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肾移植后的高脂血症

Hyperlipidemia following renal transplantation.

作者信息

Ibels L S, Alfrey A C, Subryan V, Weil R

出版信息

Trans Am Soc Artif Intern Organs. 1976;22:46-53.

PMID:781985
Abstract

In a series of 175 adult renal transplant patients 59% of patients had hyperlipidemia. Hyperlipidemia in these patients was characterized by both hypercholesterolemia and hypertriglyceridemia and on lipoprotein electrophoresis was demonstrated to be a mixture of types IIa, IIb and IV hyperlipoproteinemia. Serum cholesterol and triglyceride levels could both be related to the dosage of prednisone these patients received. Serum triglyceride levels could further be correlated with obesity and negatively with the duration of graft function. The latter relationship was felt to reflect the lower dose of prednisone that was administered the longer the duration of graft function. Hypertriglyceridemia was more prevalent in the 47 transplant patients who received kidneys from cadaver donors than in the 128 patients who received kidneys from related-donors. The cadaver-donor renal transplant patients, however, were receiving a larger maintenance dose of corticosteroids and had had functioning transplants for a shorter period of time. In 17 patients followed for up to 20 wks immediately following transplantation both hypercholesterolemia and hypertriglyceridemia developed within 8 wks of transplantation and persisted for the remaining 12 wks. Both serum cholesterol and triglyceride levels in this early post-transplant phase could be related to the cumulative prednisone dosage.

摘要

在一组175例成人肾移植患者中,59%的患者患有高脂血症。这些患者的高脂血症表现为高胆固醇血症和高甘油三酯血症,脂蛋白电泳显示为IIa型、IIb型和IV型混合性高脂蛋白血症。血清胆固醇和甘油三酯水平均与这些患者接受的泼尼松剂量有关。血清甘油三酯水平还与肥胖相关,与移植肾功能持续时间呈负相关。后一种关系被认为反映了移植肾功能持续时间越长,泼尼松的给药剂量越低。接受尸体供肾的47例移植患者中高甘油三酯血症比接受亲属供肾的128例患者更普遍。然而,尸体供肾肾移植患者接受的皮质类固醇维持剂量更大,移植肾功能正常的时间更短。在17例移植后立即随访长达20周的患者中,高胆固醇血症和高甘油三酯血症均在移植后8周内出现,并在剩余的12周内持续存在。移植后早期阶段的血清胆固醇和甘油三酯水平均与泼尼松累积剂量有关。

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