成人原发性肾病综合征患者血清脂蛋白 (α)的检测及其意义(英文)

Lipoprotein(α) levels in adult patients with primary nephrotic syndrome

目的 进一步探讨脂蛋白(α)[LP(α)]在成人原发性肾病综合征(PNS)发生发展中的作用。方法 应用单克隆抗体浊度法检测76例PNS患者血清LP(α)水平,分析不同病理类型PNS患者血清LP(α)是否存在差异;并对LP(α)水平与PNS患者病情严重程度以及与其它血脂项目的关系作相关分析。结果 PNS患者血清LP(α)水平显著高于正常对照组(P<0.005);各病理类型血清LP(α)水平差异无统计学意义(P>0.05);PNS患者血清LP(α)水平与24h尿蛋白排泄量(24h-UPE)呈正相关,与血清白蛋白(ALB)水平呈负相关关系;PNS患者血清LP(α)水平与血清甘油三酯(TG)及极低密度脂蛋白(VLDL)水平呈高度正相关关系,而与胆固醇(CH)及低密度脂蛋白(LDL)相关性无统计学意义,也与高密度脂蛋白(HDL)相关关系无统计意义。结论 血中LP(α)异常升高可能参与PNS的发病过程;LP(α)代谢异常与PNS的原发病因无关,PNS发生后所继发的机体代谢异常可能是引起血清LP(α)水平升高的主要原因;积极诱导PNS缓解或者尽可能的降低尿蛋白不仅对控制肾脏内损伤具有巨大意义,而且对减少肾外并发症的发生具有重要意义。

Objective: To further explore the role of lipoprotein(α) in the clinical development of patients with primary nephritic syndrome(PNS). Methods:Sera LP (α) levels in 76 adult patients with PNS and 40 normal controls were detected by enzyme-linked immunoadsordent assay (ELISA). The differences of sera levels of LP (α) in different pathological type of PNS were analyzed. The relationship between sera levels of LP (α) and sera levels of albumin, triglyceride(TG), cholesterol(CH), very low dense lipoprotein(VLDL), low dense lipoprotein(LDL), high dense lipoprotein(HDL) and 24 hour urinary protein excretion(24 hUPE)were also analyzed.Results:Level of LP(α) was increased significantly when compared to that of normal controls ( P <0.005). No significant difference was found among the levels of LP (α) in PNS patients with different pathological type. The levels of sera LP (α) were correlated with sera levels of ALB negatively and 24 h UPE positively ( P <0.05); The levels of sera LP (α) were also correlated positively with sera levels of TG and VLDL, but were not correlated with CH, LDL and HDL ( P >0.05) . Conclusions:The increasing of LP (α) may play a role in renal injury and the complication of PNS. Secondary factors other than primary factors are the reasons of sera LP (α) elevation. Controlling urinary protein excretion is not only important for renal protection but also for complication prevention of PNS.