Tsai Ming-Hsien, Fang Yu-Wei, Leu Jyh-Gang
Division of Nephrology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, No. 95 Wen-Chang Road, Shih-Lin District, Taipei 111, Taiwan ; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, No. 17 Hsu Chow Road, Zhongzheng District, Taipei 100, Taiwan.
Division of Nephrology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, No. 95 Wen-Chang Road, Shih-Lin District, Taipei 111, Taiwan.
ScientificWorldJournal. 2014;2014:486781. doi: 10.1155/2014/486781. Epub 2014 Nov 13.
As a low-molecular-weight heparin, tinzaparin has effectively been used as an anticoagulant during hemodialysis sessions. However, the impact of different heparin types on dyslipidemia is still controversial. In our study, 434 chronic hemodialysis patients were evaluated. The mean age was 65 ± 13. Forty-eight patients (11%) and 386 patients (89%) were in the tinzaparin and unfractionated heparin (UFH) groups, respectively. Triglyceride had significant difference between the two groups (P = 0.001) but total cholesterol, HDL, or LDL did not. In the univariate analysis, the triglyceride level was significantly associated with tinzaparin use [β: -39.9, 95% confidence interval (CI): -76.7 to -3.0], and this association remained following the multivariate analysis (β: -40.8, 95% CI: -75.1 to -6.5). The difference in serum total cholesterol level between tinzaparin and UFH became significant (β: -13, 95% CI: -24.5 to -1.56) after adjustment in the multivariate analysis. Moreover, in a subgroup analysis, male diabetic patients showed lower serum triglyceride levels with the use of tinzaparin, while older, nondiabetic, male patients showed significant advantages in total cholesterol levels with the use of tinzaparin. Based on our findings, tinzaparin shows a significant association with a lower lipid profile in patients with chronic hemodialysis when compared to UFH.
作为一种低分子量肝素,替扎肝素已有效地用作血液透析期间的抗凝剂。然而,不同类型肝素对血脂异常的影响仍存在争议。在我们的研究中,对434例慢性血液透析患者进行了评估。平均年龄为65±13岁。替扎肝素组和普通肝素(UFH)组分别有48例患者(11%)和386例患者(89%)。两组之间甘油三酯有显著差异(P = 0.001),但总胆固醇、高密度脂蛋白或低密度脂蛋白无显著差异。在单因素分析中,甘油三酯水平与替扎肝素的使用显著相关[β:-39.9,95%置信区间(CI):-76.7至-3.0],多因素分析后这种关联仍然存在(β:-40.8,95%CI:-75.1至-6.5)。在多因素分析调整后,替扎肝素和UFH之间血清总胆固醇水平的差异变得显著(β:-13,95%CI:-24.5至-1.56)。此外,在亚组分析中,男性糖尿病患者使用替扎肝素时血清甘油三酯水平较低,而老年非糖尿病男性患者使用替扎肝素时在总胆固醇水平方面显示出显著优势。根据我们的研究结果,与UFH相比,替扎肝素与慢性血液透析患者较低的血脂水平显著相关。