慢性肾功能衰竭患者血清脂蛋白(α)的检测及其意义

Sera Lipoprotein(α) levels in patients with chronic renal failure

目的 探讨脂蛋白 (α) [LP (α) ]在慢性肾功能衰竭 (CRF)进行性发展及肾外并发症发生、发展中的作用。方法 应用免疫比浊法检测 4 0例正常人和 92例CRF患者血清LP (α)水平。结果 CRF患者与正常对照者血清LP (α)水平间差别有显著性意义 (P <0 0 0 1) ;肾功能损害程度不同的CRF患者血清LP (α)水平间差别无显著性意义 (P >0 0 5 ) ,而不同病因的CRF患者血清LP (α)水平间差别有显著性意义 (P <0 0 0 1) ,以糖尿病肾病为最高。CRF患者血清LP (α)水平与血清肌酐 (Scr)无相关关系 (P >0 0 5 ) ,而与总胆固醇 (CH)、甘油三酯(TG)水平及低密度脂蛋白 (LDL)、极低密度脂蛋白 (VLDL)水平均呈不同程度的相关关系 (P <0 0 0 1)。结论 LP (α)在CRF肾损伤进行性恶化以及心血管并发症的发生、发展过程中可能起重要作用。CRF本身所继发的物质代谢紊乱或者有毒代谢产物的潴留可能不是导致LP (α)上升的主要原因 ,而CRF的原发病则至少是引起CRF患者血清LP (α)水平升高的主要原因之一 ;在CRF早期 ,积极调整该因子的代谢紊乱可能对延缓CRF患者肾功能进一步损害及肾外并发症、特别是心血管并发症的发生具有较大的意义。

Objective To further explore the role of lipoprotein(α)〔LP(α)〕 in the advance of chronic renal failure(CRF) and its complication occurrence and progress.Methods Sera LP(α) levels in 92 patients with CRF and 40 normal controls were measured by immuno-turbidimetry method.Results The level of LP(α) in patients with CRF was increased significantly when compared with that of normal controls(P<0.001);No significant difference was found among the levels of LP(α)in CRF patient with different renal damage stages (P>0.05).But the levels of LP(α)were significantly different among the CRF patients with different origin pathogens(P<0.001 ),and the highest is in patients with diabetic renal disease. The levels of sera LP(α)were not correlated with sera creatinine (Scr) levels(P>0.05) but correlated positively with sera levels of triglyceride (TG),very low dense lipoprotein (VLDL),cholesterol (CH )and low dense lipoprotein (LDL)(P<0.001) separately.Conclusion The increase of LP(α)may play an important role in worse renal damage of CRF and the process of complication occurrence and progress. Primary etiological factors rather than CRF itself are the main reasons of sera LP(α)elevation. Controlling LP(α)metabolism disorder is important not only for renal protection but also for complication prevention of CRF.