Hörkkö S, Huttunen K, Läärä E, Kervinen K, Kesäniemi Y A
Department of Internal Medicine, University of Oulu, Finland.
Ann Med. 1994 Aug;26(4):271-82. doi: 10.3109/07853899409147902.
Plasma lipids, chemical composition of various lipoprotein fractions, apolipoprotein B concentrations and apolipoprotein E phenotypes were studied in 12 uraemic patients on conservative treatment (CT), in 16 patients on haemodialysis (HD) and in 18 patients on continuous ambulatory peritoneal dialysis treatment (CAPD). Plasma total cholesterol and triglyceride concentrations were increased in the CAPD patients in comparison to the HD patients and the control subjects. Moreover, the CAPD patients had higher LDL cholesterol concentration than the CT and HD patients. The HDL cholesterol concentration was lower in the HD and CAPD patients than in the control subjects. The chemical composition of lipoproteins in all fractions of the CT and HD patients and in VLDL, IDL and LDL fractions of the CAPD patients differed from those of the control subjects. The main differences were the increased proportion of triglycerides in VLDL and LDL fractions of all the patient groups and in HDL fraction of the CT and HD patients in comparison to the control subjects. Moreover, the proportion of cholesterol was increased in VLDL and IDL fractions of the CT and the CAPD patients and decreased in HDL fraction of the CT and HD patients compared to the control subjects. In conclusion, in addition to the alterations in the lipoprotein concentrations in uraemic patients there are also marked changes in the chemical composition of the lipoprotein particles that may further contribute to the accelerated atherosclerosis among uraemic patients. The abnormalities are particularly prevalent in CAPD patients.
对12例接受保守治疗（CT）的尿毒症患者、16例接受血液透析（HD）的患者和18例接受持续性非卧床腹膜透析治疗（CAPD）的患者的血浆脂质、各种脂蛋白组分的化学组成、载脂蛋白B浓度和载脂蛋白E表型进行了研究。与HD患者和对照组相比，CAPD患者的血浆总胆固醇和甘油三酯浓度升高。此外，CAPD患者的低密度脂蛋白胆固醇浓度高于CT患者和HD患者。HD患者和CAPD患者的高密度脂蛋白胆固醇浓度低于对照组。CT患者和HD患者所有组分以及CAPD患者的极低密度脂蛋白（VLDL）、中间密度脂蛋白（IDL）和低密度脂蛋白组分中的脂蛋白化学组成与对照组不同。主要差异在于，与对照组相比，所有患者组的VLDL和LDL组分以及CT患者和HD患者的HDL组分中甘油三酯比例增加。此外，与对照组相比，CT患者和CAPD患者的VLDL和IDL组分中胆固醇比例增加，CT患者和HD患者的HDL组分中胆固醇比例降低。总之，除了尿毒症患者脂蛋白浓度的改变外，脂蛋白颗粒的化学组成也有显著变化，这可能进一步导致尿毒症患者动脉粥样硬化加速。这些异常在CAPD患者中尤为普遍。
