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[低分子量肝素:它如何改变慢性血液透析患者的脂质代谢?]

[Low molecular weight heparin: how does it modify lipid metabolism in chronic hemodialysis patients?].

作者信息

Schneider H, Schmitt Y

机构信息

Zentrum für Innere Medizin, Katharinenhospital Stuttgart, FRG.

出版信息

Klin Wochenschr. 1991 Oct 18;69(16):749-56. doi: 10.1007/BF01797613.

Abstract

22 patients on chronic hemodialysis underwent low-molecular-weight-heparine (LMWH) (Fragmin, Kabi Chemie Corp., München) instead of conventional heparine (CH) for anticoagulation during dialysis. Blood evaluations before start, 2, 4 and 6 months under LWMH treatment and 3 and 6 months after switching back to CH were performed. During LWMH-treatment whole cholesterol decreased significantly, LDL-cholesterol being the main part accounting for this. HDL-cholesterol and the subfractions of HDL-cholesterol remained nearly unchanged. The apolipoproteins A1 and B decreased significantly, too. Apolipoprotein B decreased during the 6 months LMWH-period continuously, while Apolipoprotein A1 rapidly decreased during the first two months and then stabilized at a lower level. The triglycerides, starting from a normal range level, increased during the first 2 months significantly, then decreased reaching the starting values again at the end of the LMWH-period. Platelet aggregation induced with collagen showed a significant improvement during the use of LMWH. After switching back to CH the parameters returned to the starting values again.

摘要

22例慢性血液透析患者在透析期间使用低分子量肝素(LMWH)(法安明,卡比化学公司,慕尼黑)而非传统肝素(CH)进行抗凝。在开始使用LMWH治疗前、治疗2个月、4个月和6个月以及换回CH治疗3个月和6个月后进行血液评估。在LMWH治疗期间,总胆固醇显著降低,其中低密度脂蛋白胆固醇是主要的降低部分。高密度脂蛋白胆固醇及其亚组分几乎保持不变。载脂蛋白A1和B也显著降低。载脂蛋白B在LMWH治疗的6个月期间持续降低,而载脂蛋白A1在前两个月迅速降低,然后稳定在较低水平。甘油三酯从正常范围水平开始,在最初2个月显著升高,然后降低,在LMWH治疗期结束时再次达到起始值。使用LMWH期间,胶原诱导的血小板聚集有显著改善。换回CH后,各项参数又恢复到起始值。

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