CAJ | 학술논문

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24 h尿蛋白排泄量(24 h-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.
목적진일보탐토지단백(α)[LP(α)]재성인원발성신병종합정(PNS)발생발전중적작용.방법응용단극륭항체탁도법검측76례PNS환자혈청LP(α)수평,분석불동병리류형PNS환자혈청LP(α)시부존재차이;병대LP(α)수평여PNS환자병정엄중정도이급여기타혈지항목적관계작상관분석.결과PNS환자혈청LP(α)수평현저고우정상대조조(P＜0.005);각병리류형혈청LP(α)수평차이무통계학의의(P＞0.05);PNS환자혈청LP(α)수평여24 h뇨단백배설량(24 h-UPE)정정상관,여혈청백단백(ALB)수평정부상관관계;PNS환자혈청LP(α)수평여혈청감유삼지(TG)급겁저밀도지단백(VLDL)수평정고도정상관관계,이여담고순(CH)급저밀도지단백(LDL)상관성무통계학의의,야여고밀도지단백(HDL)상관관계무통계의의.결론혈중LP(α)이상승고가능삼여PNS적발병과정;LP(α)대사이상여PNS적원발병인무관,PNS발생후소계발적궤체대사이상가능시인기혈청LP(α)수평승고적주요원인;적겁유도PNS완해혹자진가능적강저뇨단백불부대공제신장내손상구유거대의의,이차대감소신외병발증적발생구유중요의의.
Objective: To further explore the role of lipoprotein (α) [ LP (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.