慢性肾功能衰竭及血液透析患者脂质代谢紊乱的分析

目探讨慢性肾功能衰竭(CRF)患者及血液透析(HD)患者脂质代谢紊乱的特点。方法慢性肾功能衰竭患者43例和正常人22例,分别取外周肝素抗凝静脉血5ml,送生化实验室检验。CRF患者按病情分期及治疗与否分为:氮质血症组、尿毒症组(未透析)、血液透析组,进行检测TG、CH、HDL、LDL、apoAⅠ、apoB-100,TG、CH采用酶法,HDL、LDL采用直接法,apoAⅠ及apoB-100均采用免疫透射比浊法。结果氮质血症组与尿毒症组(未透析)各项指标盖异不显著,均表现为LDL升高而HDL则降低,与对照组差异显著;血液透析组主要表现为TG和LDL升高,HDL则下降;apoA各组均降低,apoB升高,且与正常对照组之间差异有统计学意义。尿毒症组与血液透析组甘油三酯和高密度脂蛋白差异显著(P＜0．05),CH在各组与时照组之间无差异,无统计学意义。结论慢性肾功能衰竭患者存在脂质代谢紊乱,主要表现为TG、LDL和apoB增高,HDL和apoA降低,而且脂质代谢紊乱与其病情相关性不大,并且血液透析并不能改善脂质代谢紊乱,甚至加重。

Study On Serum Lipid Metabolism In Patients With Chronic Renal Failure Receiving Hemodialy

Objective To explore the feature of lipid metabolic disturbance in paitents with chronic renal failure (CRF).Methods 42 cases with chronic renal failure(CRF)and 22 healthy subjects being used as a control guoup,which heparinized blood were collected 5 ml to be sended to the biochemistry lab.According to the conditions of the disease and intervention study,the patients of CRF were divided into three groups:azotemic guoup,uraemic group(non-dialysis)and haemodialysis group.They were detected in the items of TG,CH,HDL,LDL,apoAI and apoB-100.The items of TG and CH were detected by enzyme method and the items of HDL was detected by PTM-Mg method.LDL was detected by PVS method, apoAI and apoB-100 were done by immunoradiological comparision turbidity method.Results There were no obvious differences between azotmic guoup and uraemic group(non-dialysistic).In the tow groups,the level of LDL increased and that of HDL decreased,and the differences were obvious compared with the control group.The main feature characterized by TG and LDL incresasing,HDL decreasing in haemodialysis group.ApoA I decreased and apoB-100 rised in every group.There were obvious differences about apoA and apoB-100 at statistics compared with the healthy control group.There were obvious diffences between uraemic group and haemodialysis group about the levels of TG and HDL,but the level of CH was no statistic value among every group and the control group.Conclusion The patients with chronic renal failure have lipid metabolic disturbance,that was the level of TG and LDL increasing and the levelof HDL and apoA decreasing,but that was not closely related with the condition of the disease.This revealed that haemodialysis cannot improve the disturbance of lipid metabolism,even worse it.