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目的研究 2型糖尿病中高脂蛋白 ( a)水平是否为肾病的独立危险因素。方法将患者分为糖尿病组和糖尿病肾病组 ,后者包括微量蛋白尿组和临床蛋白尿组 ,均采用辛伐他丁分组治疗 ,对治疗前后糖尿病肾病患者脂蛋白 ( a)水平、尿微白蛋白排泄率和肌酐清除率的变化进行对比。结果 1三组患者血浆脂蛋白 ( a)水平与尿微白蛋白排泄率成正相关 ,与肌酐清除率成负相关。 2辛伐他丁干预 14周后 ,三组患者血浆脂蛋白 ( a)水平均显著下降 ( P<0 .0 5 ) ,但尿微白蛋白排泄率、肌酐清除率无变化。结论糖尿病患者高脂蛋白 ( a)水平可能不是并发早期糖尿病肾病的独立危险因素 ,而是肾病所导致的结果。
Objective To investigate whether the level of high-density lipoprotein (a) in type 2 diabetes is an independent risk factor for nephropathy. Methods The patients were divided into diabetic group and diabetic nephropathy group. The latter group included microalbuminuria group and clinical proteinuria group. All patients were treated with simvastatin. Before and after treatment, the levels of lipoprotein (a) Protein excretion rate and creatinine clearance changes were compared. Results The level of plasma lipoprotein (a) in three groups of patients was positively correlated with urinary albumin excretion rate and negatively correlated with creatinine clearance rate. After 14 weeks of simvastatin intervention, the levels of plasma lipoprotein (a) decreased significantly in all three groups (P <0.05), but there was no change in urinary albumin excretion rate and creatinine clearance rate. Conclusion The level of hyperlipoprotein (a) in diabetic patients may not be an independent risk factor for early diabetic nephropathy, but the result of nephropathy.