原发性肾病综合征患儿血脂代谢紊乱的肾毒性作用

目的探讨原发性肾病综合征患儿(PNS)血脂代谢紊乱与肾功能改变的关系。方法2004 01—2006 01，根据肾功能检查结果，将广西医科大学第一附属医院儿科收治的76例PNS患儿分成无肾功能损害组(46例)与肾功能损害组(30例)，检测血浆总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、非 高密度脂蛋白(non HDL)、低密度脂蛋白(LDL)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、ApoA1/B、血浆尿素氮(BUN)、肌酐清除率(Ccr)和尿酸(UA)等指标。结果(1)肾功能损害组TG、BUN、Ccr和UA均明显高于无肾功能损害组；(2)76例PNS患儿TG与Ccr及UA呈高度正相关(P<0.01)，ApoA1与Ccr呈中度正相关(P<0.05)，ApoB与UA呈中度正相关(P<0.05)；(3)76例PNS患儿non HDL与LDL呈高度正相关(P<0.01)。结论PNS合并肾功能损害的血脂代谢紊乱以TG显著增高为特征；TG和non HDL变化可以作为临床判断PNS患儿肾功能损害程度及调脂措施有效性的指标。

Nephrotoxicity induced by dyslipidemia in children with primary nephritic syndrome.

AbstractObjectiveTo probe into the relationship between dyslipidemia and the alternation of renal function in children with primary nephritic syndrome(PNS).MethodsTotally 76 children with PNS were divided into two groups,the non renal inadequacy group(46 children) and the renal inadequacy group(30 children),according to renal function.Total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),non HDL,low density lipoprotein(LDL),apolipoprotein A1(ApoA1),apolipoprotein B(ApoB),ApoA1/B,blood urea nitrogen(BUN),creatinine clearance rate(Ccr) and uric acid(UA) in plasma were detected.Results(1) TG,BUN,Ccr and UA in the renal inadequacy group significantly increased compared with the non renal inadequacy group.(2) There was outstanding positive correlation between TG and Ccr,UA(P<0.01),medium positive correlation between ApoA1 and Ccr(P<0.05),medium positive correlation between ApoB and UA(P<0.05)in 76 PNS children.(3) Outstanding positive correlation was observed between non HDL and TG(P<0.01)in 76 PNS children.ConclusionSignificantly increased TG is the feature of dyslipidemia in PNS children complicating renal inadequacy.It is favorable identification for TG,non HDL to judge the degree of renal inadequacy and the efficacy of therapy in clinic.