原发性肾病综合征患儿血脂代谢紊乱与肾功能损害的关系探讨

Nephrotoxicity Induced by Dyslipidemia in Children with Primary Nephritic Syndrome

目的探讨原发性肾病综合征患儿（PNS）血脂代谢紊乱与肾功能改变的关系。方法2004—04-2007—04，黑龙江省医院道外分院和哈尔滨市第二医院收治的57例PNS患儿，根据肾功能检查结果分成无肾功能损害组（34例）与肾功能损害组（23例），检测高密度脂蛋白（HDL）、非-高密度脂蛋白（non—HDL）、低密度脂蛋白（LDL）、载脂蛋白A1（ApoAl）、载脂蛋白B（ApoB）、血浆总胆固醇（TC）、甘油三酯（TG）、ApoAl／B、血浆尿素氮（BUN）、肌酐清除率（Ccr）和尿酸（ua）等指标。结果（1）肾功能损害组TG、BUN、Ccr和UA均明显高于无肾功能损害组；（2）57例PNS患儿TG与Ccr及UA呈高度正相关（P〈0．01），ApoAl与Ccr呈中度正相关（P〈0．05），ApoB与uA呈中度正相关（P〈0．05）；（3）57例PNS患儿non—HI）L与LDL呈高度正相关（P〈0．01）。结论PNS合并肾功能损害的血脂代谢紊乱以TG显著增高为特征：TG和non—HDL变化可以作为临床判断PNS患儿肾功能损害程度及调脂措施有效性的指标。

Objeetive To probe into the relationship between dyslipidemia and the alternation of renal function in chil - dren with primary nephritic syndrome （PNS）.Methods Totally 57 children with PNS were divided into two groups, the non- renal inadequacy group （34 children） and the renal inadequacy group （23 children）, according to renal func- tion. Total cholesterol （TC）, triglyceride （TG）, high density lipoprotein （HDL）, non - HDL, low density lipoprotein （LDL）, apolipopro - rein A1 （ APOAI）, apolipoprotein B （ APOB）, APOAl/B, blood urea nitrogen （BUN）, creatinine clearance rate （Ccr） and u-ric acid （UA） in plasma were detected. Results （1）TG, BUN, Ccr and UA in the renal inadequacy group significantlyincreased compared with the non- renal inadequacy group. （2）There was outstanding positive correlation between TG and Ccr, UA（ P 〈 0.01）, medium positive correlation between ApoA1 and Ccr （ P 〈 0.05） ,medium positive correlation between APOB and UA （ P 〈 0.05） in 57 PNS children. （3） Outstanding positive correlation was observed between non- HDL and TG （ P 〈 0.01） in 57 PNS children. Conclusion Significantly increased TG is the feature of dyalipidemia in PNS children complicating renal inadequacy. It is favorable identification for TG, non - HDL to judge the degree of renal in - adequacy and the efficacy of therapy in clinic.