原发性肾病综合征患儿血清低密度脂蛋白胆固醇理论预测值与实测值的差异

目的:比较原发性肾病综合征(primary nephrotic syndrome,PNS)患儿血清低密度脂蛋白胆固醇(low densitylipoprotein-cholesterol,LDL-C)理论预测值与实测值之间的差异。方法:78例PNS患儿,血清甘油三酯(triglyeride,TG)浓度均小于4.5 mmol/L,根据血清总胆固醇(total cholesterol,TC)水平,将其分成TC<6.21mmol/L组(29例)和TC≥6.21 mmol/L组(49例);液体双试剂法直接检测血清LDL-C浓度,并与Friedewald公式及Planella公式计算结果进行比较。结果:①PNS患儿LDL-C浓度三种测算方法之间存在显著性差异(P<0.05);②TC≥6.21 mmol/L时,Friedewald公式预测值与实测值之间未见显著性差异(P>0.05);③两种公式预测值与实测值均存在显著正相关,当TC≥6.21 mmol/L时,Friedewald公式预测值与实测值相关性最明显(R=0.79,P=0.00)。结论:当TC≥6.21 mmol/L且TG<4.5 mmol/L时,Friedewald公式预测值与实测值最为接近,可以为临床评价PNS患儿血清LDL-C水平提供参考。

Difference between estimation and direct measurement of low density lipoprotein cholesterol in children with primary nephrotic syndrome

Objective:To compare the difference between estimation and direct measurement of low density lipoprotein cholesterol(LDL-C) in children with primary nephrotic syndrome(PNS).Methods:78 PNS children,serum concentration of triglyeride (TG)<0.45 mmol/L,were divided into the following 2 groups according to their total cholesterol(TC) level,TC<6.21 mmol/L group(29 cases) and TC≥6.21 mmol/L group(49 cases);Direct measurement of LDL-C by liquid double-reagent was compared with Friedewald and Planella formula.Results:①There were significant differences among 3 methods detecting serum concentration of LDL-C in PNS children(P<0.05);②When TC≥6.21 mmol/L,significant difference was not found between Friedewald formula and direct measurement(P>0.05);③The 2 formulas were correlative with the direct measurement respectively,especially when TC≥6.21 mmol/l,the positive correlation between Friedewald formula and direct measurement was most significant(r=0.79,P=0.00).Conclusion:When TC≥6.21 mmol/L and TG<0.45 mmol/L,the estimation of Friedewald formula approachs to direct measurement superlatively,which could be used to evaluate the serum LDL-C level of PNS children in clinics.