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目的观察激素耐药性和频繁复发性肾病综合征患儿血脂代谢的变化。方法根据对激素治疗的反应,将82例肾病综合征患儿随机分为激素耐药组45例与勤复发组37例,另选同期来我院体检的健康患儿38例作为对照组。比较所有患儿血脂质、血脂蛋白、肾功能以及24 h尿蛋白定量的变化情况。结果激素耐药组、勤复发组患儿的血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)均显著高于对照组,差异均具有统计意义(P<0.05);激素耐药组患儿的TC,TG,LDL-C,ApoB、24 h尿蛋白定量、血肌酐(Scr)、肌酐清除率(Ccr)、血尿素氮(BUN)明显高于勤复发组,差异均具有统计意义(P<0.05),而白蛋白(Alb)差异无统计意义(P>0.05)。结论激素耐药性与频繁复发性的肾病综合征患儿脂质代谢异常较为严重,本研究为临床治疗该病提供了临床依据。
Objective To observe the changes of blood lipid metabolism in children with steroid resistance and frequent recurrent nephrotic syndrome. Methods Based on the response to hormone therapy, 82 children with nephrotic syndrome were randomly divided into steroid resistant group (45 cases) and diligence group (37 cases). Another 38 healthy children were enrolled in this study. The changes of blood lipid, serum lipoprotein, renal function and 24 h urinary protein in all children were compared. Results The serum total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), apolipoprotein B ApoB) were significantly higher than those in the control group (P <0.05). The levels of TC, TG, LDL-C, ApoB, 24 h urinary protein, serum creatinine (Ccr), blood urea nitrogen (BUN) were significantly higher than those in atopy relapse group (P <0.05), but albumin (Alb) had no statistical significance (P> 0.05). Conclusion The abnormalities of lipid metabolism in children with steroid resistance and recurrent nephrotic syndrome are more serious. This study provides a clinical basis for clinical treatment of the disease.