维生素E修饰的透析膜对血液透析患者血脂的影响

目的观察VitE修饰的透析膜对血液透析患者血脂的影响.方法 40名稳定血液透析患者随机分为2组.A组(n=20)用VitE修饰的透析膜透析;B组(n=20)用纤维素透析膜透析,观察4周.分别于第1次和第13次透析前抽血,测定血浆和红细胞中丙二醛(MDA)、VitE及血浆中的甘油三酯(TG)、总胆固醇(TCH)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、脂蛋白ALp(a)]、载脂蛋白B(ApoB)、载脂蛋白A1(ApoA1)浓度.结果 A组实验结束比实验前血浆VitE(P=0.003)和红细胞中VitE(P=0.032)明显升高,血浆MDA(P=0.043)和红细胞内MDA(P=0.033)明显下降.TC、TG、LDL、HDL无明显变化,但Lp(8)(P=0.049)、ApoB(P=0.040)明显下降,ApoA1(P=0.027)较前明显升高.B组实验前后观察指标无明显变化.结论使用VitE修饰的透析膜透析有抗氧化作用,改善脂质代谢,有助于防止动脉粥样硬化.

Effects of vitamin E - modified dialysls membrane on lipid for haemodialysis patients

Objective To evaluate the effects of vitamin E-modified dialysis membrane on lipid for patients on haemodialysis. Methods In our study, 40 patients on maintenance haemodialysis were divided into two groups randomly. Patients in group A (n=20) received haemodialysis with VitE-modified membrane; patients in group B(n=20) received haemodialysis merely with conventional dialyzers for a period of four weeks. Blood samples were collected prior to the first and thirteenth dialysis sessions to determine the concentrations of malonylaldehyde (MDA) and vitamin E in plasma and red blood cells (RBC), and of triglyceride (TG), total cholesterol (TCH), low density lipoprotein (LDL), high density lipoprotein (HDL), lipoprotein A Lp(a)], apolipoprotein B (ApoB) and apolipoprotein A1 (ApoA1) in plasma. Results In group A, as compared with the parameters at the initiation of the study, it was demonstrated that there was significant increase in Vit E in both plasma (P=0.003) and RBC (P=0.032), and obvious decline in MDA in both plasma (P=0.043) and RBC (P=0.033); it was also demonstrated that there was no marked changes in TC, TG, LDL and HDL, but obvious decline in Lp(a) (P=0.049) and ApoB (P=0.040) and significant increase in ApoA1(P=0.027). In Group B, there was, however, no significant changes detected at all in all the relevant parameters upon conclusion of the study. Conclusion Our study demonstrates that Vit E-modified membrane may have anti-oxidant effects on haemodialysis patients, and exhibit an advantage in improving lipoprotein metabolism, conducive to the prevention of atherosclerosis.