连续性不卧床腹膜透析患者脂蛋白a和甲状旁腺素的动态变化及相关性.doc

作者简介 张瑞青（1970- ），副主任医师，Emeil：HYPERLINK mailto:zhongmzrq@126.comzhongmzrq@126.com 通讯作者 严海东 博士生导师，主任医师，Emeil：yhdcmu@ 连续性不卧床腹膜透析患者脂蛋白a和甲状旁腺素的动态变化及相关性 张瑞青 王奕 严海东 同济大学附属东方医院肾内科 200120 【摘要】 目的　观察连续性不卧床腹膜透析(CAPD)患者脂蛋白a和甲状旁腺素（PTH）的动态变化及其相关性。方法　动态观察50例行CAPD患者开始透析前、透析后6个月以及透析后12个月的脂蛋白a和其他相关血脂指标。同时观察患者的血清PTH水平和血钙、血磷的变化以及营养指标：前白蛋白、白蛋白、血红蛋白、nPNA和透析充分性：KT/V、Ccr和残余肾功能：iGFR。并对以上指标作统计学相关性分析。 结果　①CAPD治疗6个月后，脂蛋白a较透析前明显升高(P0. 05)；PTH亦升高，但无统计学意义（P0. 05）。②CAPD治疗12个月后，脂蛋白a较透析前明显升高 (P0. 01); PTH亦显著升高（P0. 05）。 = 3 \* GB3 ③脂蛋白a和PTH的水平呈明显的正相关。 结论　脂蛋白a升高和继发性甲状旁腺功能亢进是CAPD患者的两个常见并发症，两者呈正相关，积极降低腹透患者的PTH水平可能改善患者的脂代谢异常，从而减少患者的心血管并发症。 【关键词】脂蛋白a；甲状旁腺素；连续性不卧床腹膜透析 Relationship between Lipoprotein A and Second Hyperpara Thyroidism in Continuous Ambulatory Peritoneal Dialysis Patients ZHANG Rui-qing，WANG Yi，YAN Hai-dong,Department of Neprology ,East Hospital ,Tongji University,Shanghai,200120 【Abstract】Objective　To investigate the relationship between lipoprotein(a) and Secondary Hyperpara Thyroidism in Continuous Ambulatory Peritoneal Dialysis （CAPD） Patients. M ethods　Blood levels of Lp(a) ,TC,TG,HDL-C,LDL-C, PTH,Calcium,Phosphorus and Pro-Alb，Alb，nPNA，Ccr，Kt/V，iGFR were measured in 50 Continuous Ambulatory Peritoneal Dialysis patients pro-and post-CAPD. Results = 1 \* GB3 ①After CAPD 6 Months,the levels of Lp(a) increased compared with those before CAPD in ESRD group (P 0. 05). the levels of PTH also increased compared with those before CAPD in ESRD group,but (P 0. 05).TG,TC,HDL-C and LDL-C levels had no statistical significance . = 2 \* GB3 ② After CAPD 12 Months,the levels of Lp(a) increased significantly compared with those before CAPD in ESRD group (P 0. 01). the levels of PTH also increased compared with those before CAPD in ESRD group (P 0. 05).TG,TC,HDL-C and LDL-C levels had no statistical significance. = 3 \* GB3 ③Blood PTH levels had significant correlation with blood levels of Lp(a). The level of PTH may have positive correlation with th Lp(a) . Conclusion　 Lp(a) increasing and sec