目的 探索代谢综合征( metabolic syndrome，MS)患者行血液灌流(hemoperfusion，HP)后血脂、血压的变化特征，阐明HP改善血压的可能机制。
方法 收集符合中华医学会糖尿病分会(CDS)MS诊断标准的患者，术前行血常规、尿常规、血电解质、血糖、血脂、肾功、肝功、输血前4项传染病指标等检查合格后行HP，灌流前检测血管紧张素Ⅰ(angiotensinⅠ，AⅠ)、血管紧张素Ⅱ(angiotensinⅡ，AⅡ)、醛固(aldosterone，Ald)、高敏C-反应蛋白(high-sensitivityC-reactive protein，hs-CＲP)、单核细胞趋化蛋白-1( monocyte chemotactic protein 1，MCP-1)、血清抵抗素。术后第1 天及第4、8、12周随访患者血压、血脂变化，并检测AⅠ、AⅡ、Ald、hs-CＲP、MCP-1、血清抵抗素。采用SPSS19.0统计软件，对结果进行单样本t检验、Pearson 相关分析等。
结果 患者术后8 周内总胆固醇(total cholesterol，TC) 、甘油三酯(triglyceride，TG)均较术前明显下降，差异有统计学意义(P＜0.05)。术后12 周内收缩压(SBP)及血清抵抗素水平较术前下降，差异有统计学意义［SBP:(143 ±15) mmHgvs(137 ±17)mmHg，P＜0.05; 抵抗素:(2.06 ±2.02) ng /mL vs(0.65 ±0.42) ng /mL，P＜0.05］。双变量相关分析显示SBP 分别与TC、抵抗素呈正相(r=0.40，P＜0.01; r = 0.29，P = 0.003)。
结论 HP 可有效改善代谢综合征患者血脂水平，可并降低血压，这可能与HP 清除血清抵抗素、血脂有关。

 

Objective To study the effects of hemoperfusion(HP)on lipid profiles and blood pressure and its mechanisms in patients with metabolic syndrome.
Methods  Blood Routine, Blood biochemical indexes, urine Routine, renal function, Liver function and four contagious indexes beforeblood transfusion were examined before HP,26 Patients with metabolic syndrome were qualified for HP.All patients were followed-up,blood pressure was monitored, levels of blood lipids, Angiotensin I（AI）,AngiotensinII（AII）,Aldosterone（Ald）,Hypersensitive C-Reactive protein,hs-CRP),Monocyte chemotactic protein 1（MCP-1)and Resistin were measured at 4 weeks,8 weeks and 12 weeks after HP. SPSS19 statistical software,including the single sample t test,Pearson correlation analysis and other methods was used to compare the results.
Results Total cholesterol(TC) and triglyceride(TG)level were significantly reduced after HP compared with the basal value within 8 weeks（P<0.05）.SBP and the Serum resistin level were decreased significantly compared with those before the treatment within 12 weeks(SBP：143±15mmHg vs 137±17mmHg,P<0.05; resistin: 2.06±2.02ng/ml vs 0.65±0.42ng/ml，P<0.05）.The Bivariate correlation analysis showed that the SBP was positively correlated with TC and Resistin（R=0.40，P=0.00；R=0.29，P=0.003）.
Conclusion HP can effectively improve blood lipid levels of patients with metabolic syndrome, and lower blood pressure, which may be related to HP removing serum resistin，blood lipids.