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目的:研究成人原发肾病综合征(PNS)肾脏病理改变与血脂代谢紊乱的关系。方法:选取成人PNS患者109例为研究对象,分析不同病理类型PNS患者血脂及血清脂蛋白代谢异常的发生率、代谢水平及胆固醇代谢异常的相关因素。结果:成人PNS患者血清总胆固醇(TC)升高、低密度脂蛋白胆固醇(LDL-C)升高、高密度脂蛋白胆固醇(HDL-C)降低、甘油三酯(TG)升高的发生率分别为89.90%、69.72%、9.17%、41.28%,高胆固醇血症占51.37%,混合型高脂血症占39.45%;微小病变型肾病(MCD)、膜性肾病(MN)、系膜增生性肾小球肾炎(Ms PGN)、局灶阶段性肾小球硬化(FSGS)组间TC、TG、LDL-C、HDL-C代谢异常发生率及代谢水平比较均无明显差别(P>0.05);病理类型为MCD及n-MCD的PNS患者,胆固醇水平均与24小时尿蛋白定量呈正相关(r=0.440,P=0.036;r=0.361,P=0.001),与血白蛋白水平无明显相关性(P>0.05)。结论:成人PNS患者血脂代谢异常以TC及LDL-C升高为主,临床分型中以高胆固醇血症及混合型高脂血症为主;病理类型为MCD及n-MCD的PNS患者,胆固醇水平均与24小时尿蛋白呈正相关,与血白蛋白水平无明显相关性。
Objective: To study the relationship between renal pathological changes and dyslipidemia in adults with primary nephrotic syndrome (PNS). Methods: A total of 109 adult patients with PNS were enrolled in this study. The incidences of lipid abnormalities, serum lipoprotein abnormalities, metabolic status and cholesterol metabolism were analyzed in patients with different pathological types of PNS. Results: The serum levels of total cholesterol (TC), LDL-C, HDL-C and triglyceride (TG) were significantly higher in adult PNS patients (89.90%, 69.72%, 9.17%, 41.28%, 51.37% respectively), mixed hyperlipidemia (39.45%), minimal change nephropathy (MCD), membranous nephropathy There was no significant difference in the metabolic rate and metabolic rate of TC, TG, LDL-C and HDL-C between patients with and without MSG (Ms PGN) and focal segmental glomerulosclerosis (FSGS) ). There was a positive correlation between the level of cholesterol and the 24-hour urinary protein in patients with PNS with pathological types of MCD and n-MCD (r = 0.440, P = 0.036; r = 0.361, P = 0.001) Correlation (P> 0.05). Conclusion: The abnormal lipid metabolism of adult patients with PNS is mainly caused by elevated TC and LDL-C, with hypercholesterolemia and mixed hyperlipidemia in clinical classification. In PNS patients with pathological types of MCD and n-MCD, Cholesterol levels were positively correlated with 24-hour urine protein and no significant correlation with serum albumin levels.