摘要
目的了解长期应用低分子肝素(LMWH)与普通肝素(UFH)抗凝对尿毒症维持血液透析(血透)患者脂质代谢的影响。方法选择维持血透4个月以上的患者29例,随机分成LMWH组(15例)和UFH组(14例),前6个月2组均按个体化在血透中使用UFH抗凝,后6个月前组改为LMWH抗凝,后组继续UFH抗凝,于动脉端血透前1次注射。2组分别于实验时、第6个月、第12个月末测血脂、脂蛋白、载脂蛋白水平。结果随透析时间延长UFH组血浆三酰甘油、低密度脂蛋白、载脂蛋白(Apo)B显著升高,高密度脂蛋白(HDL)、ApoA1明显降低。LMWH组第6个月各项参数与UFH组同期相当,而第12个月又恢复至实验时水平且与UFH组同期比较差异有统计学意义。结论在维持血透中以LMWH代替UFH长期抗凝可改善脂质代谢紊乱,减少动脉粥样硬化。
Objective To find out the effect of low molecular weight heparin （LMWH） and unfractionated heparin （UFH） on lipid metabolism in hemodialysis patients. Methods Twenty-nine hemodialysis patient were randomly divided into two groups： UFH group（n = 14） and LMWH group （n = 15）. UFH was infused into all patients respectively according to individual dosage during hemodialysis in first six months. UFH was used in UFH group and LMWH in LMWH group in the second six months. The level of serum lipid, lipoprotein, apolipoprotein were measured at months 0,6 and 12 of trial. Results Serum concentrations of TG, LDL, ApoB evidently increased and serum concentrations of HDL,ApoA1 evidently decreased as dialysis time went by in UFH group. The concentration of TC increased, but no significant in two groups. There were no sig- nificant difference in parameters above between the two groups at start and the first six months of trial. Contrary to UFH group at the second six months of trial, serum concentrations of TG, LDL, ApoB significantly decreased and serum concentrations of HDL, ApoA1 increased in LMWH group. Conclusion The long-term use of LMWH instead of UFH for anticoagulation during dialysis has beneficial effects on lipid metabolism.
出处
《华中医学杂志》
2008年第1期38-40,共3页
Central China Medical Journal
关键词
血液透析
普通肝素
低分子肝素
脂质代谢
Hemodiaiysis
Unfractionated heparin
Low molecular weightheparin
Lipometabolism
