内科

目的观察慢性肾衰竭（CRF）患者血清脂蛋白（a）〔LP（a）〕水平的变化及其与心脑血管疾病的关系。方法回顾分析102例慢性肾衰竭患者的临床及实验室资料，探讨患者血LP（a）水平与心脑血管疾病的关系。结果CRF患者无论透析与否，其血LP（a）水平均较健康对照组显著升高（P＜0.05），血液透析组（HD组）LP（a）水平升高及高密度脂蛋白（HDL-C）水平下降比非透析组（ND）更明显（P＜0.01），而HD组与ND组患者血总胆固醇（CHOL）、低密度脂蛋白（LDL-C）、三酰甘油（TG）浓度差异无统计学意义。CRF伴心脑血管疾病患者的血LP（a）水平比无心脑血管疾病患者明显升高（P＜0.05）。结论CRF患者存在严重的脂代谢紊乱，血LP（a）水平升高可能伴随纤溶功能的低下，可能是CRF患者并发心脑血管疾病的危险因素之一。

ObjectiveTo observe the changes of lipoprotein(a)［lp(a)］ in patients with chronic renal failure (CRF) and analyze its relation with cardiocerebral disease.MethodsThe clinical and laboratory data of 102 patients with CRF were collected and analyzed.The correlation between Lp(a) and cardiocerebral disease was investigated.ResultsThe average level of serum Lp(a) in CRF patients was significantly higher than that in control group(P＜0.01).The average level of serum HDL-C in HD group was significantly lower than that in control group(P＜0.01).No difference was found in serum TG,LDL-C,CHOL between HD group and non-HD group.The serum Lp(a) level was positively correlated with cardiocerebral disease.ConclusionDisorder of lipid metabolism exist in CRF patients.The markedly elevated level of Lp(a) in CRF patients indicates that the renal function may have the effect on the metabolism of Lp(a).The increased synthesis of LP(a) by liver which is stimulated by the low plasma level of albumin may contribute to the high level of LP(a) in patients with CRF.Serum level of LP(a) is positively correlated with and clinical manifestations.LP(a) may be a risk factor of cardiacocerebral disease.

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