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儿童肾病综合征的血脂代谢异常 被引量：1

Abnormalities of lipid metabolism in children with nephrotic syndrome
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摘要 探讨儿童肾病综合征血脂代谢异常的特点及其与肾病临床状态和预后的关系。方法对３０例肾病综合征患儿血清脂类、脂蛋白及载脂蛋白水平追踪观察。结果肾病发作期以ＴＣ和ＬＤＬ－Ｃ水平显著升高为主，其升高幅度与血清白蛋白浓度呈显著负相关（ｒ＝－０．５５，Ｐ＜０．０５；ｒ＝－０．６１，Ｐ＜０．０１），伴有ＶＬＤＬ－Ｃ、ＴＧ、ａｐｏ－Ｂ１００升高，ＬＤＬ－Ｃ无明显变化。激素治疗８周后激素敏感型患儿ＨＤＬ－Ｃ明显升高（Ｐ＜０．０１），其余脂类水平降低，６月后完全恢复正常；非激素敏感型患儿治疗８周后血脂各项指标与治疗前比较无显著差异，３／６例ＴＣ、ＨＤＬ－Ｃ水平增高持续至１年后。结论肾病患儿脂类代谢异常可持续很长时间并增加肾小球硬化和动脉硬化的危险性。 Objective To investigate the abnormalities of lipid metabolism in children with nephrotic syndrome(NS), and relationship between the abnormalities and clinical state and prognosis of NS. Methods Fasting serum lipid profiles were investigated in 30 children with nephrotic syndrome before treatment, after 8 weeks of steroid therapy and 12 months after recovery. Ten children with acute glomerulonephritis(AGN) and 10 healthy children (aged 2￣12 years) were also studied as diseased and normal control groups. Results The nephrotic children showed significantly increased levels of total serum cholesterol (TC), lowdensity lipoprotein cholesterol (LDLC), very lowdensity lipoprotein cholesterol (VLDLC), triglycerides (TG) and apolipoproteins A1 and B100 (apoA1 and apoB100), while their highdensity lipoprotein cholesterol (HDLC) level was not different from that of controls. The levels of LDLC and TC were inversely corelated with those of serum albumin. After treatment with prednisone for eight weeks and lowlipid diet, children with steroidsensitive NS had a significant elevation of HDLC and reduction of TC, LDLC, VLDLC, TG and apoB100, compared with pretreatment levels, though the values were still higher than control. The lipid levels were completely normal after six months. Children with partial response to steroid therapy had persistent elevation of LDLC and TC at 8 weeks and 12 months. Conclusions The abnormalities of lipid metabolism may persist for a long time in nephrotic children, and lead to an increased risk of glomerulosclerosis and atherosclerosis, and it is necessary to treat steroid partial response nephrotic children with lowering hyperlipemia agents.
作者 鹿玲 张传荣 周亚熙 杨正修 胡波
机构地区 安徽医科大学第一附属医院儿科
出处 《安徽医科大学学报》 CAS 1997年第6期699-702,共4页 Acta Universitatis Medicinalis Anhui
关键词 儿童 肾病综合征 血脂代谢异常 nephrotic syndrome/metab lipids/blood lipoproteins, LDL/blood cholesterol/blood child
分类号 R726.92 [医药卫生—儿科]
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  • 7Teng B, Ishida B, Forte T M, et al. Effective lowering of plasma, LDL, and esterified cholesterol in LDL receptor-knockout mice by adenovirus-mediated gene delivery of ApoB mRNA editing enzyme ( Apobecl ) [ J ]. Arterioscler Thromb Vasc Biol, 1997, 17 (5) : 889 - 97.
  • 8Han S, Vaziri N D, Gollapudi P, et al. Hepatic fatty acid and cholesterol metabolism in nephrotic syndrome [ J ]. Am J Transl Res,2013,5 (2) :246 -53.
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安徽医科大学学报
1997年 第6期

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