儿童原发性肾病综合征血清酰化刺激蛋白及补体C3水平的变化

Levels of serum acylation-stimulating protein and C3 in children with primary nephrotic syndrome

目的观察原发性肾病综合征(PNS)患儿血清酰化刺激蛋白(ASP)、补体C3水平的变化以及与血脂的关系。方法分别检测35例未经治疗的PNS患儿(蛋白尿组)和25例缓解期PNS患儿(缓解组)空腹血清ASP、C3、白蛋白及血脂水平,并与35例体重指数相匹配的正常儿童(对照组)进行比较。结果蛋白尿组血清ASP水平(101±22 nmol/L)高于缓解组(32±8 nmol/L)及对照组(33±8 nmol/L)(P<0.01),而血清C3水平在3组之间差异无统计学意义。蛋白尿组血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、载脂蛋白B(apoB)水平明显升高,血清白蛋白(ALB)水平明显降低,与缓解组和对照组比较,差异有统计学意义(P<0.01)。蛋白尿组血清ASP浓度与补体C3、TG水平呈显著正相关(r=0.661,0.354;P<0.05),补体C3与TG无显著相关性(r=0.319,P>0.05)。结论 PNS患儿血清ASP水平升高,推测与机体对抗高脂血症有关。

Objective To study serum acylation-stimulating protein（ASP） and complement 3（C3） levels and their relationship with blood lipids in children with primary nephrotic syndrome（PNS）.Methods Blood samples were obtained from 35 PNS children with proteinuria,25 children with PNS at remission and 35 body mass index-matched healthy children（control group）.Fasting serum ASP,C3,albumin and blood lipids were measured.Results The serum ASP levels in the proteinuria group（101±22 nmol/L） were significantly higher than those in the remission group（32±8 nmol/L） and the control group（33± 8 nmol/L）（P0.01）.Serum C3 levels were not significantly different among the three groups.The serum concentrations of total cholesterol,triglyceride,low density lipoprotein and apolipoprotein B increased,in contrast,serum albumin level decreased significantly in the proteinuria group when compared with the remission and the control groups.Serum ASP levels were positively correlated with serum C3（r=0.661;P0.05） and triglyceride levels（r=0.354;P0.05）,whereas serum C3 levels were not correlated with serum triglyceride levels（r=0.319,P0.05）.Conclusions The increased serum ASP level may be associated with a complemental mechanism against hyperlipidemia in children with PNS.