目的：探討尿毒癥維持性血透(MHD)患者營養(yǎng)不良、炎癥與脂質(zhì)代謝紊亂三者間的相關(guān)關(guān)系，以及對心血管并發(fā)癥的預測。方法:測51例尿毒癥維持性血透患者血清總膽固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、載脂蛋白(Apo)A1、ApoB、脂蛋白（a）LP(a)、白蛋白(ALB)、C反應(yīng)蛋白(CRP)、血清鐵蛋白（SF），與30例正常人進行對照研究。結(jié)果：MHD患者TG、LDL、ApoB、LP(a)、CRP、SF顯著增高,HDL、ApoA1、ALB顯著降低(P＜0.05)；隨著透析時間的延長，各項檢測指標變化進一步加重；且心血管事件發(fā)生者血清CRP和LP(a)明顯增高，ALB明顯降低，血脂紊亂更顯著。相關(guān)性分析：ALB與HDL、ApoA1正相關(guān)，與CRP、LP(a)、TC、TG、ApoB負相關(guān)；CRP與LP(a)、TC、TG、ApoB、LDL、SF正相關(guān)，與HDL、ApoA1負相關(guān)，P均＜0.05。結(jié)論：MHD患者存在明顯的脂質(zhì)代謝紊亂、炎癥和營養(yǎng)不良，三者的相互促進和影響可能是心血管事件發(fā)生的危險因素。
引用本文： 左川,謝席勝,李孜,樊均明,邱紅渝. 維持性血透患者營養(yǎng)不良、炎癥與脂質(zhì)代謝紊亂的相關(guān)性分析. 華西醫(yī)學, 2008, 23(1): 48-50. doi: 復制
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| 12. | Danielski M，Ikizler TA，McMonagle E，et al.Linkage of hypoalbuminemia，inflammation，and oxidative stress in patients receiving maintenance hemodialysis therapy[J].Am J Kidney Dis,2003,42:286-294.Morewr M,CristalJP,Canaud B.Blood Psuif,2000,18:191-199. |
- 1. Himmelfarb J.Relevance of oxidative pathways in the pathophysiology of chronic kidney disease[J].Cardiol Clin,2005,23(3):319-330.
- 2. 王海燕.腎臟病學[M].北京:人民衛(wèi)生出版社，1996:597.
- 3. Stenvinkel P,Heimburger O,Paultre F,et al.Strong association between malnutrition，inflammation，and atherosclerosis in chronic renal failure[J].KidneyInt，1999，55（5）：1899-1911.
- 4. Menon V，Wang X，Greene T，et al.Relationship between C-reactive protein，albumin，and cardiovascular disease in patients with chronic kidney disease[J].Am J Kidney Dis，2003，42（1）：44-52.
- 5. Prieto D,Benedito S,Simonsen U,et al.Regional heterogeneity in the contractile and potentiating effects of neuropeptide Y in rat isolated coronary arteries:Modulatory action of endothelium[J].Br J Pharmacol,1991,102(3):754-758.
- 6. Kalantar ZK,Stenvinkel P,Bross R,et al.Kidney insufficiency and nutrient-based modulation of imflammation[J].Curr Opin Clin NutrMetab Care,2005,8(4):388-396.
- 7. Efendic E,Lindholm B,Bergstrom J,et al.Strong connection between malnutrition,inflammation and arteriosclerosis.Improved treatment of renal failure if underlying factors are attacked[J].Lakartidningen,1999,96(42):4538-4542.
- 8. Bergstrom J,Lindholm B.Malnutrition,cardiac disease,and mortality:an integrated point of view[J].Am J Kidney Dis,1998,32(5):834-841.
- 9. Tetta C,Biasioli S,Schiavon R,et al.An overview of haemodialysis and oxidant stress[J].Blood Purif,1999,17:118－126.
- 10. Morena M,Cristol JP,Canaud B,et al.Why hemodialysis patients are in a prooxidant state?What could be done to correct the pro/antioxidant imbalance[J].Blood Purif,2000,18(3):191-199.
- 11. Wratten ML,Navino C,Tetta C,et al.Haemolipodialysis[J].Blood Purif,1999,17:127-133.
- 12. Danielski M，Ikizler TA，McMonagle E，et al.Linkage of hypoalbuminemia，inflammation，and oxidative stress in patients receiving maintenance hemodialysis therapy[J].Am J Kidney Dis,2003,42:286-294.Morewr M,CristalJP,Canaud B.Blood Psuif,2000,18:191-199.