慢性肾脏病患者血清胎球蛋白A水平与脂质代谢紊乱的相关性研究

目的 观察未接受透析治疗的慢性肾脏病（CKD）3～5期患者血清胎球蛋白A水平变化，探讨CKD患者血清胎球蛋白A水平与脂质代谢紊乱的相关性。方法将2008年8月至2009年1月我院64例CKD患者分为3组，其中CKD3期组17例，CKD4期组16例，CKD5期组31例，另选择健康体检者20名为对照组，分别检测各组血清胎球蛋白A水平以及清蛋白（Alb）、三酰甘油（TG）、总胆固醇（TC）、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A（ApoA）、载脂蛋白B（ApoB）、脂蛋白aLP（a）]、血肌酐（SCr）、尿素氮（BUN）、半胱氨酸蛋白酶抑制剂C（cystatinc）、血钙（Ca^2＋）、血磷（p3＋）、甲状旁腺素（PTH），比较各组胎球蛋白A水平，并分析血清胎球蛋白A水平的独立影响因素。结果CKD3期组血清胎球蛋白A水平与对照组无差异（P〉0．05），CKD4期组和CKD5期血清胎球蛋白A水平较对照组降低（P〈0．05），ApoA、ApoB、ApoA／ApoB比值和cystatinC被选人多元线性回归模型。结论CKD非透析患者血清胎球蛋白A水平可能随着肾功能的逐步恶化而降低，其水平与脂质代谢紊乱相关。

Correlation between serum fetuin A concentration and disorder of lipid metabolism in patients with chronic kidney disease

Objective To investigate the serum level of fetuin A in non-dialysis patients with chronic kidney disease （CKD） stage 3-5, and explore the association of fetuin A with disorder of lipid metabolism. Methods Sixty-four patients in our hospital during Aug. 2008 to Jan. 2009 were divided into three subgroups according to glomerular filtration rate （GFR）： CKD stage 3 group （17 cases）, CKD stage 4 group （16 cases）, CKD stage 5 group （31 cases）, and 20 healthy volunteers served as control group. The indexes such as serum fetuin A, cholesterol, and triglyceride were tested. The serum level of fetuin A among four groups was compared, and the independent factors of fetuin A were explored. Results There was no significant difference in the serus fetuin A level between CKD stage 3 group and control group （P〉0. 05）, and the serum fetuin A levels in CKD stage 4 group and CKD stage 5 group were lower than in control group （P〈0. 05）. Apolipoprotein A （ApoA）, apolipoprotein B （ApoB）, ApoA/ApoB and cystatin C were selected into the model of multiple linear regression. Conelusion Serum fetuin A levels are decreased with the deterioration of renal function in non-dialysis patients who suffered CKD in middle or end stage. There is correlation between fetuin A and disorder of lipid metabolism in non-dialysis patients.