肾病综合征病儿血清载脂蛋白的变化

SERUM APOLIPOPROTEIN ALTERATIONS IN CHILDREN WITH NEPHROTIC SYNDROME

目的探讨原发性肾病综合征（简称肾病）病儿血脂代谢特点及其意义。②方法对４９例肾病病儿不同病期血清脂类和载脂蛋白（ａｐｏ）的水平进行检测。③结果肾病活动期血清总胆固醇（ＴＣ），甘油三酯（ＴＧ）和ａｐｏ－Ｂ１００显著增高，ＴＣ和ＴＧ水平与ａｐｏ－Ｂ１００水平皆呈正相关（ｒ＝０．６５７，０．３６０，Ｐ＜０．０１，０．０５），ａｐｏ－Ｂ１００水平与白蛋白水平呈负相关（ｒ＝－０．５８３，Ｐ＜０．０１）；肾病缓解初期血清ＴＣ，ａｐｏ－Ｂ１００水平仍增高，而ＴＧ恢复正常；无论活动期还是缓解初期，血清ａｐｏ－ＡⅠ水平皆无明显变化；活动期单纯性肾病和肾炎性肾病间血清ＴＣ，ＴＧ，ａｐｏ－ＡⅠ和ａｐｏ－Ｂ１００水平差异皆无显著性。④结论肾病病儿活动期和缓解初期血清载脂蛋白和血脂显著异常，对激素非敏感性病儿有必要给予降脂药物治疗。

\ Objective \ To investigate the abnormalities of lipid metabolism and its significance in children with primary nephrotic syndrome(NS).\ Methods \ Fasting serum lipids and apolipoproteins were detected in 49 children with NS at different stages.\ Results \ Children with active NS showed significantly increased levels of total serum cholesterol(TC), triglycerides(TG) and apolipoproteins B100(apoB100). The levels of TC and TG were positively correlated with that of apoB100(r=0.657, 0.360, P<0.01, 0.05). There was a negative correlation between serum apoB100 and serum albumin (r=0.583, P<0.01). During the early remission of NS, there were increments of TC and apoB100, while TG returned to normal. Serum level of apoA1 showed no significant change in either active or remission stages of the patients. No significant differences were observed in serum levels of TC, TG, apoA1 and apoB100 between patients with simple NS and those with nephritis NS.\ Conclusions \ The results suggested that there were marked abnormalities of serum apolipoproteins and lipids in NS children at active stage and early remission. It is necessary to treat nonsteriod sensitive NS children with hypolipemia agents.