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肾移植前后的脂质紊乱

Lipid disturbances before and after renal transplant.

作者信息

Razeghi Effat, Shafipour Mohammadreza, Ashraf Haleh, Pourmand Gholamreza

机构信息

Urology Research Center, Sina Hospital, Medical Sciences/University of Tehran, Hassan-Abad Sq., Tehran, Iran.

出版信息

Exp Clin Transplant. 2011 Aug;9(4):230-5.

PMID:21819366
Abstract

OBJECTIVES

Hyperlipidemia is a significant metabolic disorder that is commonly encountered in renal transplant recipients. This study was conducted to investigate lipid disturbances and define its pattern in kidney recipients.

MATERIALS AND METHODS

The records of 103 patients who had undergone a renal transplant between the years of 2004 and 2005 were retrospectively investigated. The lipid profile of these patients including total cholesterol, low-density lipoproteins, high-density lipoproteins, and triglyceride levels before and within 2 years' follow-up after transplant was evaluated. The demographics of the patients, cause of the end-stage renal failure, along with their immunosuppressive regimens were also considered.

RESULTS

The study group included 43 women (41.8%) and 60 men (58.2%) (mean age, 39.25 ± 13.9 y). After transplant, laboratory analyses yielded significantly increased levels of total cholesterol, low-density lipoproteins, triglyceride levels, and high-density lipoproteins despite statin therapy, and the most important predictor for developing hypercholesterolemia and hypertriglyceridemia-pre-existing dyslipidemia. The effects of the various drugs on lipid metabolism were not different. These effects seen on the lipid profiles also were independent of the patients' age, sex, and cause of end-stage renal failure.

CONCLUSIONS

Despite statin treatment, renal transplants in our subjects were associated with a characteristic pattern of lipid disturbance with raised total cholesterol, low-density lipoproteins, high-density lipoproteins, and a concomitant increase in triglycerides. A more-aggressive approach to managing posttransplant hypercholesterolemia is warranted, especially in patients with pre-existing dyslipidemia.

摘要

目的

高脂血症是肾移植受者中常见的一种重要代谢紊乱疾病。本研究旨在调查肾移植受者的脂质紊乱情况并确定其模式。

材料与方法

回顾性调查了2004年至2005年间接受肾移植的103例患者的记录。评估了这些患者在移植前及移植后2年随访期间的血脂谱,包括总胆固醇、低密度脂蛋白、高密度脂蛋白和甘油三酯水平。还考虑了患者的人口统计学特征、终末期肾衰竭的病因及其免疫抑制方案。

结果

研究组包括43名女性(41.8%)和60名男性(58.2%)(平均年龄39.25±13.9岁)。移植后,尽管使用了他汀类药物治疗,但实验室分析显示总胆固醇、低密度脂蛋白、甘油三酯水平和高密度脂蛋白水平均显著升高,而发生高胆固醇血症和高甘油三酯血症的最重要预测因素是移植前已存在的血脂异常。各种药物对脂质代谢的影响并无差异。这些血脂谱变化也与患者的年龄、性别和终末期肾衰竭的病因无关。

结论

尽管使用了他汀类药物治疗,但我们研究对象的肾移植仍伴有特征性的脂质紊乱模式,即总胆固醇、低密度脂蛋白、高密度脂蛋白升高,同时甘油三酯也随之升高。对于移植后高胆固醇血症的管理,尤其是对于移植前已存在血脂异常的患者,有必要采取更积极的治疗方法。

相似文献

1
Lipid disturbances before and after renal transplant.肾移植前后的脂质紊乱
Exp Clin Transplant. 2011 Aug;9(4):230-5.
2
A long-term study on hyperlipidemia in stable renal transplant recipients.一项关于稳定期肾移植受者高脂血症的长期研究。
Clin Transplant. 2004 Jun;18(3):274-80. doi: 10.1111/j.1399-0012.2004.00160.x.
3
Prospective monitoring of lipid profiles in children receiving pravastatin preemptively after renal transplantation.肾移植后接受普伐他汀预防性治疗儿童的血脂谱前瞻性监测。
Pediatr Transplant. 2005 Dec;9(6):746-53. doi: 10.1111/j.1399-3046.2005.00373.x.
4
Beneficial effects of atorvastatin in the treatment of hyperlipidemia after renal transplantation.阿托伐他汀在肾移植术后高脂血症治疗中的有益作用。
Wien Klin Wochenschr. 2000 Apr 21;112(8):358-61.
5
Effects of immunosuppressive drugs on serum lipid levels in renal transplant recipients.
Transplant Proc. 2006 Mar;38(2):502-5. doi: 10.1016/j.transproceed.2005.12.052.
6
Treatment with ezetimibe in kidney transplant recipients with uncontrolled dyslipidemia.依折麦布用于血脂异常未得到控制的肾移植受者的治疗。
Transplant Proc. 2008 Nov;40(9):2925-6. doi: 10.1016/j.transproceed.2008.09.046.
7
Tacrolimus-induced elevation in plasma triglyceride concentrations after administration to renal transplant patients is partially due to a decrease in lipoprotein lipase activity and plasma concentrations.肾移植患者服用他克莫司后血浆甘油三酯浓度升高,部分原因是脂蛋白脂肪酶活性和血浆浓度降低。
Transplantation. 2009 Jul 15;88(1):62-8. doi: 10.1097/TP.0b013e3181aa7d04.
8
Disturbed lipids, lipoproteins and triglyceride-rich lipoproteins as well as fasting and nonfasting non-high-density lipoprotein cholesterol in post-renal transplant patients.肾移植术后患者的脂质、脂蛋白及富含甘油三酯的脂蛋白紊乱,以及空腹和非空腹非高密度脂蛋白胆固醇情况。
Ren Fail. 2007;29(6):705-12. doi: 10.1080/08860220701460111.
9
Correlation of C0 and C2 levels with lipid profiles in adolescent renal transplant recipients in the early and late posttransplant periods.青少年肾移植受者移植早期和晚期C0及C2水平与血脂谱的相关性
Transplant Proc. 2006 Jun;38(5):1286-9. doi: 10.1016/j.transproceed.2006.02.073.
10
Dyslipidemias in patients with diabetes mellitus: classification and risks and benefits of therapy.糖尿病患者的血脂异常:分类及治疗的风险与益处
Pharmacotherapy. 1995 May-Jun;15(3):317-37.

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