透析病人脂蛋白(α)的变化及其与心脑血管事件的关系  

Change of lipoprotein(α) in dialysis patients and its relationship with cardiac and cerebral events

作　　者：蔡楚丹[1] 蔡聪[1] 卢娟娟[1] 卓乐莹[1] 李通泰[1] 

机构地区：[1]汕头大学医学院第一附属医院肾脏内科,515041

出　　处：《中国基层医药》2003年第7期586-588,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的　研究血透 (HD)与腹透 (PD)病人脂蛋白 (α) [Lp(α) ]水平变化及意义。 方法　分析 4 5例HD及 5 0例PD病人临床及实验室资料 ,比较两种透析方法对Lp(α)及脂质水平影响的差别 ,分析Lp(α)与其他相关因素的关系。结果　两组TG和ApoB均显著增高 ,HDL C显著降低。两组Lp(α)水平均较对照组显著升高 (P <0 0 5 ) ,PD组较HD组更高 (P <0 0 1) ;两组病人Lp(α)水平与UCG、ECG异常及心脑血管事件发生、TC及LDL C浓度正相关 ;而与ALb浓度负相关。结论　透析病人脂质代谢紊乱常见 ,以PD更突出 ,其中Lp(α)、TG、HDL C变化尤显著 ,Lp(α)Objective To observe the changes of lipoprotein(α) in patients with end stage renal disease(ESRD) treated by hemodialysis(HD) and peritoneal dialysis(PD).Methods Clinical data and laboratory data of 95 dialysis patients(45 patients on HD and 50 patients on PD) were collected and alayzed.The effects of different dialysis methodes on Lp(α) and other lipids were compared and the roles of Lp(α) in the complications in these groups of patients were examined.Results Comparing with cotrol group,the average serum level of TG and ApoB increased and HDL C decreased significantly in both PD and HD groups.The average serum level of Lp(α) was significantly higher in HD and PD patients than that in the control group(P<0.05),and the average serum level of Lp(α) was significantly higher in PD group than that in HD group.The positive correlation was found between the serum level of Lp(α) and clinical manifestations(abnormal echocardiography,ECG and cardiac and cerebral vascular events).The negative correlation was discovered between the serum level of Lp(α) and the plasma level of albumia.Conclusion Hyperlipidemia is quite common in dialysis patients,which is more severe in PD patients.The increasing serum level of Lp(α) and TG and decreasing serum level of HDL C may be the risk factors for increasing cardiac and/or cerebral vascular events.

关 键 词：脂蛋白(Α) 心脑血管疾病 血透透析 腹透透析 并发症 尿毒症 

分 类 号：R459.5[医药卫生—治疗学]