CKD 3~5期患者血脂水平特点及其与肾功能指标的关系
| 作者: |
1刘会红
1 皖西卫生职业学院附属医院检验科，安徽 六安 237008 |
| 通讯: |
刘会红
Email: 1501834819@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2022.01.007 |
摘要
目的：探讨慢性肾脏病(chronic kidney disease，CKD)3~5期血脂水平特点以及与肾功能指标的关系。方法：选取2018年8月至2020年10月皖西卫生职业学院附属医院肾内科收治的247例CKD患者(3期64例，4期34例，5期149例)，记为CKD组。另选取70例体检健康志愿者记为对照组。比较不同分期CKD患者血清三酰甘油(triglyceride，TG)、总胆固醇(total cholesterol，TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol，LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol，HDL-C)水平并归纳血脂异常构成情况，采用Pearson相关性分析CKD患者血脂水平与肾功能指标[血肌酐(serum creatinine，Scr)、肾小球滤过率(glomerular filtration rate，GFR)]的关系。结果：CKD 3~5期患者血清TC、LDL-C水平比较，差异无统计学意义(P>0.05)，随CKD分期增加，血清TG、HDL-C水平逐渐下降(P<0.05)，CKD 3期血清TG、HDL-C高于CKD 5期，CKD 4期血清HDL-C水平高于CKD 5期，差异有统计学意义(P<0.05)。CKD 3~5期血脂异常率59.92%，明显高于对照组的12.86%(P<0.05)。CKD 3期、4期、5期血脂异常率分别为59.38%、61.76%、59.73%，差异无统计学意义(P>0.05)。CKD 3~5期患者血脂异常类型以高三酰甘油血症、低高密度脂蛋白胆固醇血症为主，分别占17.41%、32.79%，且随CKD分期增加，低高密度脂蛋白胆固醇血症比重显著升高，差异有统计学意义(P<0.05)。Pearson相关性分析显示CKD 3~5期患者血清TG、HDL-C水平与血清Scr水平均呈负相关(r=−0.436、r=−0.850，P<0.05)，与GFR均呈正相关(r=0.472、r=0.717，P<0.05)。结论：CKD 3~5期患者血脂异常率较高，血脂异常类型以高TG、低HDL-C为主，且随CKD分期增加，低HDL-C愈发明显，血清TG、HDL-C水平与肾功能进展紧密相关。
关键词：
慢性肾脏病；血脂；肾功能；相关性
Characteristics of blood lipid level and its relationship with renal function indexes in patients with chronic kidney disease stage 3–5
CorrespondingAuthor: LIU Huihong Email: 1501834819@qq.com
DOI: 10.3978/j.issn.2095-6959.2022.01.007
Abstract
Objective: To investigate the characteristics of blood lipid level in 3–5 stage of chronic renal disease (CKD) and the relationship between it and renal function indexes. Methods: From August 2018 to October 2020, 247 patients with CKD (64 cases in stage 3, 34 cases in stage 4 and 149 cases in stage 5) in the Department of Nephrology, Affiliated Hospital of Wanxi Health Vocational College were selected as CKD group. Another 70 healthy volunteers were selected as the control group. The levels of serum triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were compared in different stages of CKD patients, and the composition of dyslipidemia was summarized. The relationship between serum lipid level and renal function indexes [serum creatinine (Scr), glomerular filtration rate (GFR)] was analyzed by Pearson correlation analysis. Results: There was no significant difference in serum TC and LDL-C levels between CKD stage 3 and 5 (P>0.05). With the increase of CKD stage, serum TG and HDL-C levels gradually decreased (P<0.05). Serum TG and HDL-C levels in CKD stage 3 were higher than those in CKD stage 5, and serum HDL-C levels in CKD stage 4 were higher than those in CKD stage 5 (P<0.05). The dyslipidemia rate of CKD stage 3–5 was 59.92%, which was significantly higher than that of the control group 12.86% (P<0.05). The dyslipidemia rates of CKD stage 3, 4 and 5 were 59.38%, 61.76% and 59.73% respectively, and the difference was not statistically significant (P>0.05). The main types of dyslipidemia in CKD stage 3–5 patients were hypertriglyceridemia and low-density lipoprotein cholesterol, accounting for 17.41% and 32.79% respectively. With the increase of CKD stage, the proportion of low-density lipoprotein cholesterol increased significantly (P<0.05). Pearson correlation analysis showed that serum TG and HDL-C levels were negatively correlated with serum SCR levels (r=−0.436, r=−0.850, P<0.05), and positively correlated with GFR levels (r=0.472, r=0.717, P<0.05). Conclusion: The incidence of dyslipidemia in patients with CKD stage 3–5 is high. The main types of dyslipidemia are high TG and low HDL-C. With the increase of CKD stage, low HDL-C is more obvious. Serum TG and HDL-C levels are closely related to the progress of renal function.
Keywords：
chronic kidney disease; blood lipid; renal function; correlation