Camici M, Evangelisti L
Metodologia Clinica, Università degli Studi, Pisa.
Minerva Med. 1992 Dec;83(12):801-4.
Ten patients have been studied for lipidic behaviour during hemodialysis using as anticoagulant heparin and prostacyclin. Hearing has been administered at infusion rate of 2000 U/h and prostacyclin in 5 ng/kg/min. Lipidic behaviour (before and after hemodialysis) has been studied for apolipoproteins A and B, total serum cholesterol and serum triglycerides, HDL-cholesterol, lipoprotein. Total serum cholesterol/HDL-cholesterol, apolipoproteins A/apolipoproteins B, apolipoproteins A/HDL-cholesterol ratios have been also studied. Our findings show that heparin produces acute changes in lipidic behaviour after hemodialysis and suggest that administrations may contribute to lipidic derangement of uremic dialytic patient while heparin free dialysis (prostacyclin infusion) doesn't show lipidic derangement after dialytic treatment. Prostacyclin infusion suggests that may be a useful anticoagulant and therapeutic drug especially in uremic dialytic subject with high atherosclerosis involvement, dyslipidemia and arterial hypertension.
我们对10例患者在血液透析期间使用肝素和前列环素作为抗凝剂时的脂质行为进行了研究。肝素以2000 U/h的输注速率给药，前列环素以5 ng/kg/min的速率给药。我们研究了血液透析前后载脂蛋白A和B、总血清胆固醇和血清甘油三酯、高密度脂蛋白胆固醇、脂蛋白的脂质行为。还研究了总血清胆固醇/高密度脂蛋白胆固醇、载脂蛋白A/载脂蛋白B、载脂蛋白A/高密度脂蛋白胆固醇的比值。我们的研究结果表明，肝素在血液透析后会引起脂质行为的急性变化，提示其给药可能会导致尿毒症透析患者的脂质紊乱，而无肝素透析（输注前列环素）在透析治疗后未出现脂质紊乱。输注前列环素表明其可能是一种有用的抗凝剂和治疗药物，尤其是对于动脉粥样硬化程度高、血脂异常和动脉高血压的尿毒症透析患者。
