中国血液净化

›› 2006, Vol. 5 ›› Issue (1): 30-32.

• 论著 • 上一篇    下一篇

血液透析患者脂代谢紊乱与心血管疾病的临床研究

1金石昆 2李守超 1李中和 1张 桦 1王玉新 1邹和群
  

  1. 519000 珠海，1中山大学附属第五医院肾内科 261041 潍坊，2山东省潍坊市人民医院肿瘤科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2006-01-12 发布日期:2006-01-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2006-01-12 Published:2006-01-12

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摘要：

目的 探讨血液透析患者血脂水平的变化对心血管疾病的影响及其相关因素分析。方法 选择中山大学附属第五医院肾内科患者测定106例血液透析患者血清总胆固醇(TC)、甘油三酯(TG) 、载脂蛋白(Apo)A1、ApoB、ApoE、脂蛋白(Lp)(a)的含量，与148例正常人进行对照研究。结果 伴心血管疾病血液透析患者血脂水平TG水平显著；年龄、透析前肌苷(SCr)、透析前尿酸(UA)、血清白蛋白(ALB)水平及伴高血压、心血管病变家族史的比例显著增高，Kt/V、透析时体外循环血量、超滤量显著低于后者。结论 年龄、高血压、TG、血清白蛋白与血磷水平是心血管疾病的重要危险因素；通过调控上述因素可减轻脂代谢紊乱、降低心血管病变的发生率。ALB、透析时体外循环血流量、血胆汁酸水平、Kt/V与脂代谢紊乱密切相关，导致血液透析患者脂质代谢紊乱进一步加重。

关键词: 脂质代谢紊乱, 血液透析, 心血管病变

Abstract:

Objective To explore the effect of serum lipid level in hemodialysis patients on cardiovascular diseases and the associated factors of cardiovascular disease. Methods Serum total cholesterol, triglyceride, Apo A1, Apo B, Apo E of 106 hemodialysis patients were determined and compared with those of 148 healthy controls. Results The levels of serum TG were significantly higher in hemodialysis patients with cardiovascular diseases. There were also an increase in age, serum creatinine, uric acid, albumin levels pre-hemodialysis and the ratios of hypertension, family histories of cardiovascular disease in these patients. Kt/V, extracorporeal circulating volume during hemodialysis and the amount of ultrafiltration were much lower in these patients than the hemodialysis patients without cardiovascular diseases. Conclusions The results suggest that age, hypertension, serum TG, albumin and phosphorus levels may be the important risk fators of cardiovascular disease. Serum albumin, extracorporeal circulating volume during hemodialysis, serum bile acid levels and Kt/V values are closely related to lipid metabolism disorders, which may induce the lipid metabolism disorders in hemodialysis patients more severely.

Key words: Hemodialysis, Cardiovascular diseases

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