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血脂异常在终末期肾脏病接受透析治疗的患者中非常普遍,然而调脂药在该类人群中应用的有效性和安全性却一直存在争议。本文通过回顾国内外相关大型随机对照试验和观察性研究,对透析患者血脂异常的影响、特点以及常见调脂药在透析患者中的应用进行梳理,旨在为特殊人群合理用药提供参考。目前的临床证据提示,在透析患者中,使用他汀类药物联合或不联合依折麦布能够有效降低血脂水平,不增加不良事件发生风险,然而在心血管保护方面作用有限;贝特类药物使用风险较高;而烟酸类药物的不良反应是限制其使用的重要因素。
Dyslipidemia is very common in patients undergoing dialysis for end-stage renal disease, but the effectiveness and safety of lipid-lowering drugs in this population have been controversial. In this paper, the review of the relevant large-scale randomized controlled trials and observational studies at home and abroad, on dialysis patients with dyslipidemia, characteristics and common lipid-lowering drugs in dialysis patients combing, designed to provide a reference for the rational use of drugs in special populations. Current clinical evidence suggests that the use of statins in combination with or without ezetimibe in dialysis patients has been shown to be effective in reducing blood lipid levels without increasing the risk of adverse events but limited in cardiovascular protection; the risk of use of fibrates Higher; and niacin drugs adverse reactions is to limit the use of an important factor.