糖尿病肾病血清脂蛋白(a)的变化及临床意义

The changes and clinical significance of serum lipoprotein (a) in patients with diabetic nephropathy

目的探讨糖尿病患者血清脂蛋白(a)[LP(A)]水平与继发糖尿病肾病的关系。方法应用单克隆抗体法测定95例糖尿病患者(包括29例无肾病组、66例肾病组)和55例健康对照者的血清LP(A)水平,酶法测血清胆固醇(CH)、甘油三酯(TG)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、空腹血糖(FBG)后进行组间比较,并分析LP(A)与尿白蛋白分泌率(UAER)的相关性。结果糖尿病肾病组血清LP(A)水平明显高于糖尿病无肾病组及对照组(P均<0.01),CH、TG和ApoB的含量比对照组显著升高(P<0.05);糖尿病肾病组LP(A)水平与肾损害的程度呈正相关(r=0.2538,P<0.05)。结论LP(A)水平与糖尿病患者有无并发糖尿病肾病及肾损害的程度有关,监测LP(A)浓度,有助于判断糖尿病患者有无并发糖尿病肾病的危险性,对糖尿病并发症的预防和控制起积极的作用。

Objective To study nephropathy. Methods A monoclonal the relationship of serum lipoprotein （a） [ LP （a） ] and second diabetic antibody was used to detect the levels of serum LP （a） in 95 patients with diabetes mellitus （including 29 cases without nephropathy group, 66 cases with nephropathy group） and 55 healthy individuals, an enzyme method was used to determine the serum cholesterol （CH）, triglyceride （TG）, apolipoprotein A1 （ApoA1）, apolipoprotein B （ApoB） and fasting blcod glucose （FBG）, and then a comparison between groups had been performed and analyzed the correlation between urinary albumin excretion （UAER） and LP（A）. Results Serum LP（A） levels were higher in diabetic nephropathy group than those in the diabetes without nephropathy group and the control group, in comparison of them, there were statistically significant difference （ P 〈0.01, respectively）. The content of CH, TG and ApoB were all higher than that in the control group, there were statistical difference （ P 〈0.05, respectively）. The correlation of serum LP（A） in diabetic nephropathy group and kidney impair degree is positive （ r = 0. 2538, P 〈 0.05）. Conclusion Serum LP（A） levels are related to whether diabetes have diabetic nephropathy complication or not and have correlation with the degree of kidney impair. Monitoring serum LP （A） levels contributes to judge whether the diabetic patients have chanciness of diabetic nephropathy and plays an active role in preventing and controlling diabetic complication.