枸橼酸钠抗凝血液透析患者血清白细胞介素-6、肿瘤坏死因子-α及血脂的变化  

Changes of the Serum Interlukin-6,Tumor Necrosis Factor-α and Lipid in Citrate Anticoagulation for Hemodialysis Patients

作　　者：李康慧[1] 尹友生[1] 覃源[1] 韦家智[1] 李小励[1] 李小红[1] 

机构地区：[1]桂林医学院附属医院泌尿内科,桂林市541001

出　　处：《广西医学》2011年第9期1103-1106,共4页Guangxi Medical Journal

基　　金：广西自然科学基金资助项目(0679016)

摘　　要：目的探讨应用枸橼酸钠抗凝血液透析患者血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、脂蛋白(a)[LP(a)]与血脂的变化及相关性。方法 90例维持性血液透析患者随机分为3组:枸橼酸钠抗凝组(A组)、普通肝素抗凝组(B组)、低分子肝素抗凝组(C组)各30例。分析3组透析前、后血清IL-6、TNF-α、LP(a)的变化;3组透析前、透析3个月、12个月及18个月后血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-c)、低密度脂蛋白胆固醇(LDL-c)、极低密度脂蛋白胆固醇(vLDL-c)的变化;分析A组IL-6、TNF-α、LP(a)与血脂的相关性。结果透析后A组IL-6下降,与透析前比较差异有统计学意义(P<0.05)。透析12个月后A组TG较透析前下降,差异有统计学意义(P<0.05),TG、LDL-c、vLDL-c低于B、C组,HDL-c高于B、C组,差异有统计学意义(P<0.05)。IL-6与TG、LDL-c、vLDL-c呈正相关(r值分别为0.553、0.521、0.512,P值分别为0.026、0.038、0.043)。结论枸橼酸钠抗凝血液透析对维持性血液透析患者血清TG、LDL-c、vLDL-c、HDL-c的影响小于肝素,可能与其较好的生物相容性有关。Objective To investigate the changes of the serum interlukin-6 （IL-6）, tumor necrosis factor-α（ TNF-α）, lipoprotein（a） [ LP（a） ] and lipid in citrate anticoagulation for hemodialysis patients and analyze the correlation. Methods Ninety maintenance hemodialysis （MHD）patients were divided randomly into three groups ,group A（n = 30）were treated with citrate,group B（ n = 30） with heparin and group C（ n = 30）with low molecular heparin. The serum IL-6, TNF-α,LP（a）were compared before and after hemodialysis in the three groups. The levels of total cholesterol（TC）, triglyceride（TG）, high density lipoprotein （HDL-c）, low density lipoprotein （LDL-c）, very low density lipoprotein （vLDL-c） were compared before hemodialysis ,3 months, 12 months and 18 months after hemodialysis. The correlations of IL-6,TNF-α, LP（a）and lipid in the patients who dialyzed with citrate were analyzed. Results After hemodialysis, the level of IL-6 decreased significantly in the group A（P 〈0.05）. After 12 months,the level of TG decreased significantly in the group A （P 〈 0. 05 ）. Compared with group B and C, the levels of TG, LDL-c, VLDL-c decreased while HDL-c increased significantly in the group A（P 〈0.05）. The levels of IL-6 was positively correlated with the levels of TG,LDL-c and VLDL-c（r =0.553,0. 521,0. 512;P =0. 026,0. 038,0. 043）. Conclusion The influences of TG,LDL-c,VLDL-c and HDL-c in MHD who are dialyzed with citrate are less than those with haperin, it is probable related to the better biocompatibility.

关 键 词：血液透析 枸橼酸钠 白介素-6 肿瘤坏死因子-Α 脂蛋白A 

分 类 号：R459.5[医药卫生—治疗学]