摘要
目的通过监测尿毒症患者血液透析(HD)、血液透析灌流(HDP)、血液透析滤过(HDF)治疗前后血清脂蛋白及相关炎症因子指标的变化,探讨三种不同血液净化方式对血清脂蛋白和炎性因子的影响。方法将48例尿毒症患者随机分为HD、HDP、HDF3组,分别于血液净化前、血液净化后4个月,检测血浆脂蛋白(a)[LP(a)]、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白B100(ApoB100)、载脂蛋白A1(ApoA1)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、脂蛋白酯酶(LPL)指标。结果 HD组血清HDL、LDL、ApoB100、ApoA1、LPL浓度HD前后无变化,LP(a)、CRP、TNF-α浓度升高;HDP组血清LP(a)、HDL、LDL、ApoB100、ApoA1、CRP、TNF-α浓度均较净化前和HD组低,LPL浓度无变化;HDF组血清LP(a)、LDL、ApoB100、CRP、TNF-α浓度均较净化前、HD组降低,LPL浓度升高,HDL、LDL、ApoB100、ApoA1、LPL浓度较HDP组高。结论 HD可激活尿毒症患者免疫炎症反应,升高血清LP(a)浓度;HDP可减少相关炎性因子、降低血脂的各项指标;HDF通过改善LPL活性降低血清LP(a)、LDL浓度,对HDL影响不大。
Objective To evaluate the influence of different blood purification ways on serum lipoprotein and inflammation factor of patients with uremic,by detecting the changes of serum lipoprotein and inflammation factor before and after treatment of HD,HDP,HDF for patients with uremic.Methods Forty eight uremic patients were randomly divided to hemodialysis（HD） group,hemodialysis perfusion（HDP） group and hemodiafiltration（HDF） group.The concentrations of lipoprotein（a）[LP（a）],high-density lipoprotein（HDL）,low-density lipoprotein（LDL）,apolipoprotein B100（ApoB100）,apolipoprotein A1（ApoA1）,C-reactive protein（CRP）,tumor necrosis factor-α（TNF-α）,and lipoprotein lipase（LPL） were respectively detected in all patients before blood purification treatment and after hemodialysis for 4 months.Results The serum concentration of HDL,LDL,ApoB100,ApoA1,LPL had no significant difference before and after the HD in HD group,the serum concentration of LP（a）,CRP,TNF-α were higher after the hemodialysis than before.The serum concentration of LP（a）,HDL,LDL,ApoB100,ApoA1,CRP,TNF-α in HDP group were lower than before and that in HD group,serum concentration of LPL had no significant difference.The serum concentration of LP（a）,LDL,ApoB100,CRP,TNF-α in HDF group were significantly lower than before and that in HD group,while serum concentration of LPL was higher;the serum concentration of HDL,LDL,ApoB100,ApoA1,LPL were obviously higher than that in HDF group.Conclusion HP can activate the immune inflammation of uremic patients,and increase the serurm LP（a） concentration;HDP can reduce related inflammation factor,and decrease the blood fat various index;HDF can reduce the concentration of serum LP（a） and LDL by improving LPL active,while does not affect the concentration of HDL.
出处
《中国当代医药》
2012年第36期60-61,63,共3页
China Modern Medicine
