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目的 研究原发性肾病综合征 (INS)患儿血载脂蛋白E(ApoE)的变化及与中分子尿蛋白的关系。 方法 检测 5 0例INS患儿血ApoE及血胆固醇 (TC)、甘油三酯 (TG)、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A1(ApoA1)、载脂蛋白B(ApoB)及血清总蛋白 (TP)、白蛋白 (Alb)、2 4h尿蛋白 (TUP)。用HYDRASYSLC(Sebia)全自动电泳分析系统测定INS患儿尿蛋白分子质量大小以确定其尿蛋白类型。以 5 0例年龄、性别相匹配的健康儿童为对照组。结果 活动期INS患儿血ApoE及血TC、TG、HDL C、LDL C、ApoB显著高于对照组 (均P <0 0 1)。 92 %INS患儿有高ApoE血症。血ApoE及血TC、TG、LDL C、ApoB与血TP、Alb呈显著负相关 (P <0 0 1) ,而血ApoE、TC、TG、LDL C、ApoB与TUP无相关。选择性中分子蛋白尿 (SMUP)组血ApoE显著高于非选择性蛋白尿 (NSUP)组 (P <0 0 1)。结论 INS患儿血ApoE明显升高 ,高ApoE血症广泛存在于INS患儿 ,血ApoE升高不能作为脂蛋白肾小球病的特异性诊断指标。中分子尿蛋白是INS患儿血ApoE升高的一个重要原因。
Objective To study the changes of blood apolipoprotein E (ApoE) in children with primary nephrotic syndrome (INS) and its relationship with urinary protein. Methods The blood levels of ApoE, TC, TG, HDL C, LDL C, ApoA 1 ), Apolipoprotein B (ApoB), serum total protein (TP), albumin (Alb), 24h urinary protein (TUP). HYDRASYSLC (Sebia) automatic electrophoresis analysis system to determine the size of urinary protein in children with INS to determine their urinary protein type. Fifty healthy children of age and sex matched as the control group. Results ApoE and TC, TG, HDL C, LDL C and ApoB were significantly higher in active children with INS than those in control group (all P <0.01). 92% of children with INS have high Apoemia. There was a significant negative correlation between blood ApoE, blood TC, TG, LDL C, ApoB and blood TP and Alb (P <0.01), but not blood ApoE, TC, TG, LDL C and ApoB. ApoE was significantly higher in the SMUP group than in the non-selective proteinuria (NSUP) group (P <0.01). Conclusions ApoE in children with INS is significantly higher than that in children with INS, and high ApoEmia is widely present in children with INS. The elevated serum ApoE can not be used as a specific diagnostic marker for glomerulopathy of lipoprotein. Urinary protein is a molecular marker of INS in children with elevated blood ApoE is an important reason.