老年Ⅱ型糖尿病性肾病脂蛋白(a)与肾功能不全的关系

Relationship between serum lipoprotein (a) levels and renal insufficiency of elderly patients with diabetic nephropathy

目的探讨脂蛋白(a)(Lp(a))与老年糖尿病性肾病肾功能不全的关系。方法分析47例老年对照组和141例不同肾小球滤过率的老年糖尿病肾病患者的脂蛋白(a)、血脂及载脂蛋白浓度的变化。结果老年糖尿病性肾病肾功能正常组Lp(a)己有升高趋势(P=0.072),随着肾功能的减退Lp(a)显著增高(P<0.001),并且与肾小球滤过率呈负相关,同时冠心病和脑血管病发生率也明显上升。结论Lp(a)升高在老年糖尿病性肾病肾功能不全的发展过程中起重要作用。

Objective To investigate the relationship between serum lipoprotein(a) (Lp(a)) levels and renal insufficiency of elderly patients with diabetic nephropathy. Methods 47 cases normal elderly control and 141 cases elderly patients with diabetic nephropathy were analysed. Results Serum Lp(a) levels in diabetic nephropathic patients with normal renal function had a elevated tendency (P = 0. 072). With the decline of renal function, serum Lp(a) levels were significantly increased (P<0. 001)and inversely correlated to creatinine clearance rate (Ccr) (P<0. 01). Meanwhile the morbidity of coronary heart disease and brain vascular disease in patients with lower Ccr was significantly elevated. Conclusion Increased serum Lp(a) levels play an important role in the progression of renal insufficiency in elderly patients with diabetic nephropathy.