肺移植对 COPD 患者血清脂质的影响。

Impact of lung transplantation on serum lipids in COPD.

机构信息

University of Maryland School of Medicine, Division of Pulmonary and Critical Care Medicine, 110 South Paca Street, Baltimore, MD 21201, USA.

出版信息

Respir Med. 2011 Dec;105(12):1961-8. doi: 10.1016/j.rmed.2011.10.003. Epub 2011 Oct 21.

DOI:10.1016/j.rmed.2011.10.003

PMID:22019328

Abstract

BACKGROUND

Severe chronic obstructive pulmonary disease is associated with high HDL cholesterol (HDL-C). We sought to examine the effect of lung transplantation on lipid profiles in patients with COPD.

METHODS

We analyzed 101 lung transplant recipients in a retrospective cohort of patients from two centers in whom lipid values were available both before as well as after transplantation. Sixty-one subjects were transplanted for severe COPD (93% GOLD stage 4).

RESULTS

Eighty-nine percent of subjects with COPD exhibited a decline in HDL-C. Median decline for the COPD cohort was 25 mg/dL (IQR 12-38 mg/dL, p < 0.0001). Non-COPD subjects exhibited no significant changes in HDL-C. Other lipid changes in the COPD cohort included a rise in triglycerides of 70 mg/dL (IQR 35 to 140, p < 0.0001). Decreases in HDL-C levels were independent from the rise in triglyceride levels. Neither LDL-C nor non-HDL-C demonstrated significant changes. Subjects with greater increases in prednisone exposure post-transplant exhibited lesser declines in HDL-C. Compared with tacrolimus, cyclosporine had no effect on observed changes in HDL-C or triglycerides, but was associated with a greater median rise in LDL-C.

CONCLUSIONS

In patients with COPD, lung transplantation results in reductions in the serum levels of HDL-C. These changes are not observed in patients undergoing lung transplantation for diagnoses other than COPD.

摘要

背景

严重的慢性阻塞性肺疾病与高密度脂蛋白胆固醇（HDL-C）升高有关。我们试图研究肺移植对 COPD 患者脂质谱的影响。

方法

我们分析了来自两个中心的 101 例肺移植受者的回顾性队列研究，这些受者在移植前后均有血脂值。61 例患者因严重 COPD（93%GOLD 分期 4 期）接受肺移植。

结果

89%的 COPD 患者 HDL-C 下降。COPD 队列的中位数下降了 25mg/dL（IQR 12-38mg/dL，p<0.0001）。非 COPD 患者的 HDL-C 无明显变化。COPD 队列中的其他脂质变化包括甘油三酯升高 70mg/dL（IQR 35-140，p<0.0001）。HDL-C 水平的降低与甘油三酯水平的升高无关。LDL-C 和非 HDL-C 均无明显变化。移植后泼尼松暴露增加的患者，HDL-C 下降幅度较小。与他克莫司相比，环孢素对观察到的 HDL-C 或甘油三酯变化没有影响，但与 LDL-C 中位数升高有关。