维持性血液透析心血管事件与脂质代谢紊乱的关系

摘要

目的：探讨维持性血液透析（MHD）患者心血管事件与脂质代谢紊乱的关系。方法对138例无明显急性心血管疾病的 MHD 患者随访3年，按是否发生心血管事件将其分为心血管事件组及非心血管事件组，比较2组血透前脂代谢指标与 C-反应蛋白（CRP）水平。结果138例患者发生心血管事件78例（56．5％）。心血管事件组三酰甘油（TG）、低密度脂蛋白（LDL）、脂蛋白（a）[LP（a）]、CRP 水平较非心血管事件组显著升高，高密度脂蛋白（HDL）水平较非心血管事件组显著降低，差异均有统计学意义（P ＜0．05）；2组总胆固醇（TC）、载脂蛋白 A （Apo-A）、载脂蛋白 B（Apo-B）水平比较差异均无统计学意义（P ＞0．05）。结论MHD 患者高 TG，高 LP（a），高LDL 及低 HDL 发生心血管事件危险性高，可能会增加其动脉粥样硬化和心血管疾病的发病率和病死率。%Objective To investigate the relationship between cardiovascular events and lipid metabolism disorders in maintenance hemodialysis (MHD)patients.Methods A total of 138 MHD patients without obvious acute cardiovascular diseases were followed up for 3 years and were divided into cardiovascular event group and non-cardiovascular event group.Lipid metabo-lism indicators and C reactive protein(CRP)levels were determined before hemodialysis.Results Among the 138 patients,cardiovascular events occurred in 78(56.5%).Compared with non-cardi-ovascular event group,levels of triglyceride(TG),low density lipoprotein(LDL),lipoprotein(a) and CRP increased and high density lipoprotein(HDL)decreased in cardiovascular event group (P <0.05).No significant differences in total cholesterol,apolipoprotein A and apolipoprotein B levels were found between the two groups(P >0.05).Conclusion MHD patients with high TG, lipoprotein(a)and LDL levels and low HDL levels are at high risk for cardiovascular events.The changes in lipid metabolism indicators may increase the morbidity and mortality of atherosclerosis and cardiovascular diseases.