中国血液净化

中国血液净化 ›› 2013, Vol. 12 ›› Issue (07): 367-370.doi: 10.3969/j.issn.1671-4091.2013.07.00

• 临床研究 • 上一篇    下一篇

脂代谢异常对腹透超滤衰竭的影响

张庆芳,安惠霞,陈晓   

  1. 哈尔滨医科大学附属第二临床医学院
  • 收稿日期:2013-01-05 修回日期:2013-05-07 出版日期:2013-07-12 发布日期:2013-07-06
  • 通讯作者: 安惠霞 E-mail:an_huixia@sina.com
  • 基金资助:
    黑龙江省教育厅科学技术研究项目

The Impact of dyslipidemia on ultrafiltration failure in peritoneal dialysis patients

  • Received:2013-01-05 Revised:2013-05-07 Online:2013-07-12 Published:2013-07-06

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摘要： 目的   探讨血脂异常对腹膜透析患者超滤衰竭的影响；方法   随机选取124名规律腹透12个月以上的患者，测定患者的ALB、Hb、T-Ch、TG、LDL-C、HDL-C、BUN、Cr、Glu水平，计算残肾功能，记录腹透龄，根据患者血脂结果分为血脂异常组和血脂正常组，比较两组腹透超滤衰竭的发生率，并以超滤衰竭与否分组，比较两组的血脂水平、肾功能、血糖、ALB、Hb的差异；结果 血脂异常组腹透超滤衰竭的发生率明显高于血脂正常组（P=0.008）；超滤衰竭组的透析龄长于超滤正常组（T=7.93,P=0.000）；超滤衰竭组的收缩压和舒张压明显高于超滤正常组（T收缩压=7.36, P收缩压=0.000，T舒张压=4.51,P舒张压=0.000）；超滤衰竭组的T-Ch、TG水平明显高于超滤衰竭正常组（TT-Ch=3.45,PT-Ch=0.001；TTG=6.76,PTG=0.000），而HDL-C水平明显低于超滤正常组（T=－7.53,P=0.000）；血脂异常组低转运水平发生率明显高于血脂正常组（P=0.021）；多因素分析显示透析龄长、低水平的HDL为腹膜透析超滤衰竭发生的独立危险因素（p透析龄长=0.034、p低水平的HDL=0.048）结论   1.腹膜透析患者血脂异常是超滤衰竭发生的原因之一，血脂异常患者腹透超滤衰竭的发生与高TG、T-Ch水平、低HDL-C水平有关；2.血脂异常患者腹透超滤衰竭可能是通过降低腹膜转运能力而发生的； 3.透析龄长、低水平的HDL为腹膜透析超滤衰竭发生的独立危险因素。

关键词: 腹膜透析, 血脂异常, 脂代谢紊乱, 超滤衰竭

Abstract: Abstrac Objective To explore the impact of  dyslipidemia on ultrafiltration failure(UFF)  in peritoneal dialysis patients. Method Choosed 124 patients who accepted  peritoneal dialysis regularly  for more than 12 months. Measured  ALB,Hb,T-Ch,TG,LDL-C,HDL-C,BUN,Cr,Glu of the patients. Recorded  the age of the patients. Patients were divided into dyslipidemia group and  normal lipid group according to the results of the blood lipid. The incidence of UFF in two groups was compared.Divided into the groups according to UFF or not. The differences of the level of  lipid 、renal function、Glu、ALB、Hb in two groups were compared. Results he incidence rate of UFF through the peritoneal dialysis in dyslipidemia group was obviously higher than in the normal blood lipids group（P=0.008）.The duration of dialysis in UFF group was longer than in the ultrafiltration normal group（T=7.93,P=0.000）.The systolic blood pressure and diastolic blood pressure in UFF group was obviously higher than in the ultrafiltration normal group（TSBP=7.36, PSBP=0.000,TDBP=4.51,PDBP=0.000）.The level of TG and T-Ch in UFF group was apparently higher than in the normal group（TT-Ch=3.45,PT-Ch=0.001；TTG=6.76,PTG=0.000）,while the level of HDL-C was obviously lower（T=－7.53,P=0.000）,The incidence rate of low peritoneal transport in dyslipidemia group was obviously higher than in the normal blood lipids group（P=0.021）.Multivariate analysis showed that long duration of dialysis and the low level of HDL were independent risk factors for ultrafiltration failure through the peritoneal dialysis.(p=0.034、0.048). Conclusion 1 Dyslipidemia in peritoneal dialysis patients is one of the causes of UFF.UFF in dyslipidemia patients is related to high TG、T-Ch level and low HDL-C level. 2. UFF in dyslipidemia patients maybe caused by deducing the turn-over capacity of the peritoneum. 3.Long term of dialysis and low HDL level are independently dangerous risks for peritoneal dialysis.

Key words: Peritoneal dialysis, Dyslipidemia, dislipidemi, ultrafiltration failure