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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。
Objective To investigate the characteristics of lipid metabolism disorders in patients with chronic renal failure (CRF) and hemodialysis (HD). Methods 43 patients with chronic renal failure and 22 patients with normal, respectively, peripheral blood anticoagulant heparin 5ml biochemical laboratory test. Patients with CRF were divided into two groups according to their stage of disease and treatment: azotemia group, uremia group (without dialysis), hemodialysis group, TG, CH, HDL, LDL, apoAⅠ, apoB-100, Enzymatic, HDL, LDL using direct method, apoA Ⅰ and apoB-100 are immunoturbidimetric method. Results There was no significant difference between azotemia group and uremia group (no dialysis), both of which showed that LDL increased and HDL decreased, which was significantly different from that of the control group. Hemodialysis group mainly manifested as elevated TG and LDL , HDL decreased; apoA decreased in each group, apoB increased, and the difference between the normal control group was statistically significant. There was significant difference of triglyceride and high density lipoprotein between uremia group and hemodialysis group (P <0.05). There was no significant difference of CH between each group and the control group. Conclusions There are lipid disorders in patients with chronic renal failure. The main manifestations are elevated TG, LDL and apoB, decreased HDL and apoA, and the correlation between lipid metabolism and their disease is insignificant. Hemodialysis does not improve lipid metabolism disorder, Even worse.