狼疮性肾炎患者经环磷酰胺治疗前后血清LP-a、HCY水平变化及其与疗效的关系

Changes of Serum LP-a and HCY Levels in Patients with Lupus Nephritis before and after Cyclophosphamide Treatment and Their Relationship with Curative Effect

目的:探讨狼疮性肾炎(LN)患者经环磷酰胺治疗前后血清脂蛋白a(LP-a)、同型半胱氨酸(HCY)水平变化及其与疗效的关系。方法:回顾性选取2013年12月至2016年12月我院收治的LN患者100例作为LN组,依据环磷酰胺治疗结果分为有效组(n=72)和无效组(n=28),同期选取门诊健康人员30例作为健康组,留取24 h尿液检测24 h尿蛋白定量(24 h UAP),采用酶联免疫吸附法检测血清LP-a、HCY水平,分析血清LP-a、HCY水平与24 h UAP、疗效的关系。结果:在24 h UAP、血清LP-a、HCY水平方面,LN组明显高于健康组,有效组明显低于无效组,有效组治疗后明显低于治疗前,差异有统计学意义(P<0.05),无效组治疗前后基本相同,差异有统计学意义(P<0.05);Pearson相关性分析结果显示,24 h UAP与血清LP-a、HCY水平呈正相关(r1=0.651,P<0.05;r2=0.688,P<0.05);Logistic回归性分析结果显示,高血清LP-a、HCY水平是LN患者治疗无效的独立危险因素(P<0.05)。结论:血清LP-a、HCY水平与LN患者的发生及其经环磷酰胺治疗后疗效转归有关,检测上述指标水平可能可作为评估患者病情及疗效的重要指标,值得临床作进一步推广。

Objective： To discuss the changes of serum lipoprotein a（ LP-a） and homocysteine（ HCY） levels in patients with lupus nephritis（ LN） before and after cyclophosphamide treatment and their relationship with curative effect.Methods： 100 patients with LN were selected as LN group from December 2013 to December 2016 in our hospital. According to the cyclophosphamide,treatment were divided into effective group（ n = 72） and ineffective group（ n = 28）.30 cases of outpatient healthy personnel were selected as healthy group,24 h urine samples were taken for quantitative determination of 24 h urinary protein,serum levels of LP-a,HCY were detected by enzyme-linked immunosorbent assay method,the relationship between serum LP-a,HCY levels and 24 h UAP,curative effects were analyzed. Results： In 24 h UAP,serum LP-a,HCY levels of LN group were significantly higher that those in healthy group,the values of effective group was significantly lower than those in ineffective group,the values of effective group after treatment was significantly lower than those in before treatment. The differences were statistically significant（ P〈0. 05）. Ineffective group before and after treatment were basically the same,the differences were statistically significant（ P〈0. 05）. Pearson correlation analysis showed that,24 h UAP and serum LP-a,HCY levels were positive（ r1= 0. 651,P〈0. 05;r2= 0. 688,P〈0. 05）; Logistic regression analysis showed that,high serum LP-a,HCY levels were the independent risk factors of ineffective treatment in patients with LN（ P〈0. 05）. Conclusions： The levels of serum LP-a,HCY are related to the occurrence of LN and the prognosis of patients after cyclophosphamide treatment,the detection of these indexes may be an important index to evaluate the patients＇ condition and curative effect,it＇s worth for further clinical promotion.