【摘要】 目的 观察维持性血液透析(maintained hernodialysis,MHD)患者血脂水平以及微炎症反应对血脂的影响。方法 选取2009年7月至2014年3月MHD患者90例,诊断均符合慢性肾脏疾病5期的诊断标准。记录患者一般临床资料,检测入院时的血脂、血沉(erythrocyte sedimentation tate,ESR)、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)和白细胞介素6(interleukin-6,IL-6)水平,分析上述炎症指标对血脂及血浆致动脉粥样硬化指数(AIP)的影响。结果 (1)90例患者中,低密度脂蛋白胆固醇升高26例(占28.9%),三酰甘油升高37例(占41.1%),总胆固醇升高31例(占34.4%),高密度脂蛋白胆固醇降低62例(占68.9%)。(2)高密度脂蛋白胆固醇降低组ESR、hs-CRP和IL-6明显高于正常组(P<0.01)。低密度脂蛋白胆固醇升高组ESR、hs-CRP和IL-6高于低密度脂蛋白胆固醇正常组(P<0.05)。三酰甘油和总胆固醇升高组和正常组ESR、hs-CRP和IL-6差异均无统计学意义(P>0.05)。(3)多元线性回归分析显示:ESR、hs-CRP和IL-6与高密度脂蛋白胆固醇水平呈负相关(r=-0.263,P<0.05),ESR、hs-CRP和IL-6与低密度脂蛋白胆固醇呈正相关(r=0.413,P<0.05),hs-CRP和IL-6与AIP呈正相关(r=0.289,P<0.05),ESR与AIP无相关性(r=0.046,P=0.725),上述炎症指标未见与三酰甘油和总胆固醇有关(r=0.038,P>0.05)。结论 MHD患者体内的微炎症反应可能影响其血脂水平。更多还原

【Abstract】 Objective To observe the levels of plasma lipid and the effects of micro-inflammatory reaction in patients with maintenance hemodialysis.Methods A total of 90 patients with maintenance hemodialysis were enrolled in this study during July 2009 to March 2014.The diagnostic criterias were consistent with stage 5 of chronic kidney disease.All the aclinical data of patients were reviewed,and a full lipid profile examination was done,including high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(HDL-C),triglyceride(TG) and total cholesterol(TC).Erythrocyte sedimentation rate(ESR),high-sensitivity C-reactive protein(hs-CRP),and interleukin-6(IL-6)were also evaluated.Atherogenic index of plasma(AIP) was calculate by the formula &g(TG/HDLC).Results(1) There were 26 cases(28.9%),37 cases(41.1%) and 31 cases(34.4%) of elevated LDL-C,TG and TC respectively.The patients with reduced HDL-C accounted for 68.9%(62 cases).(2) ESR,hs-CRP and IL-6 were significantly higher in decreased HDL-C group than in normal HDL-C group(P<0.01),ESR,hs-CRP and IL-6 were higher in elevated LDL-C group than in normal LDL-C group(P<0.05),and they had no statistically significant difference between the TG and TC groups(P>0.05).(3)Multiple linear regression analysis revealed that ESR,hs-CRP and IL-6 were negatively correlated with HDL-C(r=-0.263,P<0.05),ESR,hs-CRP and IL-6 were positively correlated with LDL-C(r = 0.413,P<0.05),hs-CRP and IL-6 were positively correlated with AIP(r= 0.289,P<0.05),ESR had no correlation with AIP(r = 0.046,P = 0.725),and the inflammation factors were not associated with TG and TC(r = 0.038,P>0.05).Conclusions The micro-inflammatory reaction in patients with maintenance hemodialysis maybe affect the levels of plasma lipid and AIP.更多还原