CAJ | 학술논문

目的：探讨特发性难治性局灶节段性肾小球硬化（FSGS）患者脂蛋白a[Lp（a）]、低密度脂蛋白胆固醇（LDL-C）、转化生长因子β1（TGF-β1）水平与疗效的相关性。方法回顾性分析134例特发性FSGS患者，根据治疗4个月时尿蛋白定量、肾功能及血清白蛋白情况分为难治组64例和激素敏感组70例，分析足量激素治疗前，治疗2、4、6个月时血清胆固醇（CHO）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、LDL-C、Lp（a）和TGF-β1水平。结果特发性FSGS难治组和FSGS激素敏感组的血清Lp（a）、TGF-β1、LDL-C均明显高于正常范围，难治组Lp（a）和TGF-β1高于激素敏感组，差异有统计学意义（ P ＜0．05）；难治组LDL-C较激素敏感组升高，但差异无统计学意义（ P ＞0．05）。经足量激素治疗4个月后，激素敏感组Lp（a）、TGF-β1、LDL-C较治疗前均明显下降，差异有统计学意义（ P ＜0．05）。难治组Lp（a）、TGF-β1、LDL-C较治疗前无明显变化，差异无统计学意义（ P ＞0．05）。结论特发性FSGS存在Lp（a）、TGF-β1的代谢紊乱，同时其升高程度可作为特发性难治性FSGS早期判定指标，早期联合其他治疗方案，减少激素不良反应。
목적：탐토특발성난치성국조절단성신소구경화（FSGS）환자지단백a[Lp（a）]、저밀도지단백담고순（LDL-C）、전화생장인자β1（TGF-β1）수평여료효적상관성。방법회고성분석134례특발성FSGS환자，근거치료4개월시뇨단백정량、신공능급혈청백단백정황분위난치조64례화격소민감조70례，분석족량격소치료전，치료2、4、6개월시혈청담고순（CHO）、감유삼지（TG）、고밀도지단백담고순（HDL-C）、LDL-C、Lp（a）화TGF-β1수평。결과특발성FSGS난치조화FSGS격소민감조적혈청Lp（a）、TGF-β1、LDL-C균명현고우정상범위，난치조Lp（a）화TGF-β1고우격소민감조，차이유통계학의의（ P ＜0．05）；난치조LDL-C교격소민감조승고，단차이무통계학의의（ P ＞0．05）。경족량격소치료4개월후，격소민감조Lp（a）、TGF-β1、LDL-C교치료전균명현하강，차이유통계학의의（ P ＜0．05）。난치조Lp（a）、TGF-β1、LDL-C교치료전무명현변화，차이무통계학의의（ P ＞0．05）。결론특발성FSGS존재Lp（a）、TGF-β1적대사문란，동시기승고정도가작위특발성난치성FSGS조기판정지표，조기연합기타치료방안，감소격소불량반응。
Objective To investigate the relationship between plasma transforming growth factor-β1 (TGF-β1 ) ,low density lipoprotein cholesterol (LDL-C)and lipoprotein(a) [Lp(a)] in focal segmental glomerulosclerosis (FSGS) .Meth-ods A total of 134 patients were enrolled in this cross-sectional study .According to urinary protein ,renal function and plasma protein after enough prednisone treatment for 4 months ,patients were divided into 64 cases as difficulty group and 70 cases as sensitive group .Level of TGF-β1 ,LDL-C and Lp(a) were analyzed before and 2 ,4 ,6 months after treatment among different groups. Results Level of plasma Lp(a) ,TGF-β1 and LDL-C were higher than normal in both groups . Lp(a)and TGF-β1 in difficulty group were higher than those in sensitive group ( P<0 .05) .Level of plasma LDL-C was not significant ( P>0 .05) .After treatment with enough prednisone for 4 months ,Lp(a) ,TGF-β1 and LDL-C were lower in sensitive group than before ( P<0 .05) .Another group was not significant ( P>0 .05) .Conclusion Level of plasma Lp(a) ,TGF-β1 was disordered in FSGS .They can be used as early marker in difficulty group.