慢性肾病患者血清脂蛋白a水平变化特点分析

The study of characteristic of serum Lp（a）level in in patients with chronic kidney disease

目的：探讨慢性肾病（CKD）患者血清脂蛋白a水平变化特点，为临床诊断治疗提供有效实验室依据。方法选取CKD患者200例，利用改良MDRD公式将其分为五期，每期40例；收集门诊健康体检正常者100例作为对照组，分别检测血清脂蛋白a浓度，数据采用SPSS 17．0统计学软件进行分析。结果 CKD组血清脂蛋白a水平（231．5±133．2）mg／L，与对照组的（115．5±70．2）mg／L比较，差异有统计学意义（Z＝－7．922，P＝0＜0．05）；CKD相邻两期之间除2期与3期比较差异有统计学意义（Z＝－2．069，P＝0．039）外，其余期间差异均无统计学意义（P＞0．05）；CKD前期（1～3期）血清脂蛋白a（182．0±110．5）mg／L，与CKD后期（4～5期）的（325．0±194．7）mg／L 差异有统计学意义（Z＝－4．439，P＜0．05）；CKD1期血清脂蛋白 a （146．0±95．5）mg／L与对照组差异有统计学意义（Z＝－2．800，P＜0．05）。结论 CKD患者血清脂蛋白a水平较健康对照组明显升高，这种情况在CKD初期就已发生，且升高程度与CKD进展程度有一定关联，提示血清脂蛋白a在CKD病程演变过程中可能起到一定的促进作用。

Objective To investigate the characteristic of lipoprotein（a）[Lp（a）]in different phases of chronic kidney disease （CKD ）,to provide the basis for clinical prevention and treatment of CKD.Methods 200 patients with CKD in the Republic Hospital of Shifang were collected as study group,including 5 phases （every phase had 40 cases）,and 100 healthy people were selected as control group.Measured the serum Lp（a）of both study and control group,analyzed the correlations between Lp（a）and different phase of CKD.All data were analyzed by SPSS version 17.0.The significant level was established at 0.05.Results CKD1 [（146.0 ±95.5）mg/L]and all CKD group [（231.5 ±133.2）mg/L]had higher level of serum Lp（a）than the control group [（115.5 ±70.2）mg/L] （Z=-2.800,P〈0.05 and Z=-7.922,P〈0.05）.CKD3 had higher Lp（a）level than CKD2（Z=-2.069,P〈0.05 ）,while there were no significant differences between each of the other two groups.CKD4 -5 [（325 .0 ± 194.7）mg/L]also had higher Lp（a）level than CKD1 -3 [（182.0 ±110.5）mg/L]（Z=-4.439,P〈0.05）. Conclusion Patients with CKD always have high level of serum Lp（a）,which have been slowly increased since CKD1 ,meanwhile the level of Lp（a）may have a certain correlation with the stage of CKD development,since Lp（a） is an important promoting factor in the progress of CKD.