中国当代儿科杂志
中國噹代兒科雜誌
중국당대인과잡지
CHINA JOURNAL OF CONTEMPORARY PEDIATRICS
2001年
2期
151-153
,共3页
曾华松%高岩%徐家喻%张小铃%陈峥嵘
曾華鬆%高巖%徐傢喻%張小鈴%陳崢嶸
증화송%고암%서가유%장소령%진쟁영
肾病综合征%高脂血症%肾脏病理%儿童
腎病綜閤徵%高脂血癥%腎髒病理%兒童
신병종합정%고지혈증%신장병리%인동
目的研究小儿肾病综合征(NS)肾脏病理与脂质紊乱的关系，为临床上正确选择合适的病例进行降脂治疗提供依据。方法行肾穿刺活检术检查NS患儿病理类型。用免疫比浊法测定了45例非微小病变型(NMCD)患儿、10例微小病变型(MCD)患儿及80例健康儿童血脂、脂蛋白、载脂蛋白3个水平共7个脂质代谢指标。结果临床表现为难治性肾病的NMCD患儿在激素正规治疗2月后仍有明显脂质紊乱，血胆固醇(TC)，三酰甘油(TG)，高密度脂蛋白胆固醇(HDL-C)，低密度脂蛋白胆固醇(LDL-C)，载脂蛋白AI(ApoAI)，载脂蛋白B(ApoB)，脂蛋白(a)［LP(a)］与对照组比较分别为(6.54±4.33) mmol/L vs (3.94±0.67) mmol/L，(3.45±2.56) mmol/L vs (0.91±0.32) mmol/L，(1.62±0.79) mmol/L vs (1.31±0.32) mmol/L，(2.69±0.87) mmol/L vs (2.15±0.58) mmol/L，(1.51±0.54) g/L vs (1.30±0.58) g/L，(1.45±0.54) g/L vs (0.67±0.16) g/L，(360.6±179.4) g/L vs (162.5±128.5) g/L，(除ApoAI P<0.05外，余均<0.01)，差异有显著性意义。而MCD患儿的脂质紊乱均恢复正常。结论 NMCD患儿脂质紊乱持续的时间较长，有更易发生进行性肾脏损害，动脉粥样硬化及冠心病的可能。此类患儿应早用降脂药物治疗。
目的研究小兒腎病綜閤徵(NS)腎髒病理與脂質紊亂的關繫，為臨床上正確選擇閤適的病例進行降脂治療提供依據。方法行腎穿刺活檢術檢查NS患兒病理類型。用免疫比濁法測定瞭45例非微小病變型(NMCD)患兒、10例微小病變型(MCD)患兒及80例健康兒童血脂、脂蛋白、載脂蛋白3箇水平共7箇脂質代謝指標。結果臨床錶現為難治性腎病的NMCD患兒在激素正規治療2月後仍有明顯脂質紊亂，血膽固醇(TC)，三酰甘油(TG)，高密度脂蛋白膽固醇(HDL-C)，低密度脂蛋白膽固醇(LDL-C)，載脂蛋白AI(ApoAI)，載脂蛋白B(ApoB)，脂蛋白(a)［LP(a)］與對照組比較分彆為(6.54±4.33) mmol/L vs (3.94±0.67) mmol/L，(3.45±2.56) mmol/L vs (0.91±0.32) mmol/L，(1.62±0.79) mmol/L vs (1.31±0.32) mmol/L，(2.69±0.87) mmol/L vs (2.15±0.58) mmol/L，(1.51±0.54) g/L vs (1.30±0.58) g/L，(1.45±0.54) g/L vs (0.67±0.16) g/L，(360.6±179.4) g/L vs (162.5±128.5) g/L，(除ApoAI P<0.05外，餘均<0.01)，差異有顯著性意義。而MCD患兒的脂質紊亂均恢複正常。結論 NMCD患兒脂質紊亂持續的時間較長，有更易髮生進行性腎髒損害，動脈粥樣硬化及冠心病的可能。此類患兒應早用降脂藥物治療。
목적연구소인신병종합정(NS)신장병리여지질문란적관계，위림상상정학선택합괄적병례진행강지치료제공의거。방법행신천자활검술검사NS환인병리류형。용면역비탁법측정료45례비미소병변형(NMCD)환인、10례미소병변형(MCD)환인급80례건강인동혈지、지단백、재지단백3개수평공7개지질대사지표。결과림상표현위난치성신병적NMCD환인재격소정규치료2월후잉유명현지질문란，혈담고순(TC)，삼선감유(TG)，고밀도지단백담고순(HDL-C)，저밀도지단백담고순(LDL-C)，재지단백AI(ApoAI)，재지단백B(ApoB)，지단백(a)［LP(a)］여대조조비교분별위(6.54±4.33) mmol/L vs (3.94±0.67) mmol/L，(3.45±2.56) mmol/L vs (0.91±0.32) mmol/L，(1.62±0.79) mmol/L vs (1.31±0.32) mmol/L，(2.69±0.87) mmol/L vs (2.15±0.58) mmol/L，(1.51±0.54) g/L vs (1.30±0.58) g/L，(1.45±0.54) g/L vs (0.67±0.16) g/L，(360.6±179.4) g/L vs (162.5±128.5) g/L，(제ApoAI P<0.05외，여균<0.01)，차이유현저성의의。이MCD환인적지질문란균회복정상。결론 NMCD환인지질문란지속적시간교장，유경역발생진행성신장손해，동맥죽양경화급관심병적가능。차류환인응조용강지약물치료。
Objective To study the relationship between hyperlipidemia and pathologic renal changes in children with the primary nephrotic syndrome(NS). Methods Forty-five children with no minimal change glomerulopathy (NMCD) (clinical type: steroid-resistent NS) and 10 children with minimal change glomerulopathy (MCD) (clinical type: steroid-sensitive NS) were compared with 80 healthy children. Seven lipoprotein metabolism parameters including serum total-cholestero1 (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein AI (ApoAI), apolipoprotein B (ApoB) and lipoprotein (a) ［Lp (a)］ were detected using enzyme methods. Results After the treatment of the children with prednisone for 2 months, lipoprotein metabolism parameters remained significantly higher in the NMCD group compared to the controls: serum TC ［(6.54±4.33) mmol/L (NMCD) vs (3.94±0.67) mmol/L (control)］, TG ［(3.45±2.56) mmol/L vs (0.91±0.32) mmol/L］, HDL-C ［(1.62±0.79) mmol/L vs (1.31±0.32) mmol/L］, LDL-C［ (2.69±0.87) mmol/L vs (2.15±0.58) mmol/L］, ApoAI ［(1.51±0.54) g/L vs (1.30±0.58) g/L］, ApoB ［(1.45±0.54) g/L vs (0.67±0.16) g/L］, Lp(a) ［(360.6±179.4) g/L vs (162.5±128.5) g/L］ (P<0.05 or 0.01). In contrast, all abnormal lipoprotein metabolism parameters in the MCD cases recovered after prednisone treatment. Conclusions There are obvious and long-term abnormialities of serum lipoprotein metabolism parameters in the NMCD group. NMCD cases should be treated with lipid-lowering drugs early, while MCD cases should not be treated with lipid lowering drugs.
