维持性血液透析患者脂质代谢紊乱与心脑血管事件相关性研究

摘要

目的探讨维持性血液透析(MHD)患者心脑血管事件发生与脂质代谢紊乱的关系。方法选取2011年1月-2012年6月中山市人民医院收治的48例慢性肾功能衰竭行维持性血液透析的患者为研究对象，测定患者血液中甘油三脂(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)及载蛋白APOB的水平，同时选取同期进行身体检查的45例健康人群进行对比分析，观察两组患者心脑血管事件发生的情况。结果 MHD患者血脂代谢紊乱表现为TG、TC、LDL、APOB增高及HDL的降低，差异具有统计学意义(P＜0.05)。MHD患者中心脑血管事件组患者与非心脑血管事件组患者比较，血脂水平显著升高，差异有统计学意义(P＜0.05)。结论 MHD患者血脂代谢紊乱的发生与维持血透的时间有关，时间越长的患者血脂代谢紊乱越严重，且其代谢紊乱过程属于不可逆转的过程，心脑血管事件的发生率也不会因此下降。MHD患者长期血透导致蛋白质流失引起机体营养不良是导致脂质代谢紊乱的主要原因。%Objective To discuss the maintenance hemodialysis (MHD) patients with cardiovascular events and lipid metabolic disorder in relation. Methods From January 2011 to June 2012 were treated in 48 patients with chronic renal failure on maintenance hemodialysis patients as research object,measured in blood of the patients with glycerin three greases (TG),total cholesterol (TC),low density lipoprotein (LDL),high density lipoprotein (HDL) and the carrier protein APOB level,at the same time chosen at physical examinations were performed on 45 healthy people were analyzed,two groups were observed in patients with cardiovascular and cerebrovascular events happened. Results The MHD of patients with disorder of lipid metabolism showed TG, TC,LDL,APOB increased,and HDL decreased,the difference was statistically significant (P<0.05). MHD patients with cerebrovascular events group of patients with a cardiovascular event group compared with patients, blood lipid levels increased significantly, the difference was statistically significant (P<0.05). Conclusion The MHD patients with disorder of lipid metabolism and the occurrence of maintenance hemodialysis is related to the time,the longer patients with disorder of lipid metabolism and more serious,and the metabolic disorder of irreversible process, incidence of adverse cardiovascular events and therefore would not fall. MHD patients with long-term hemodialysis causes protein loss caused by malnutrition is the main reason caused disorder of lipid metabolism.