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目的 了解小儿肾病综合征 (简称肾病 )时脂代谢异常的特点。方法 对 30例肾病患儿、30例急性肾炎患儿和 2 0例无肝肾疾病儿童的血脂变化进行了对比分析 ,并观察了其中 14例肾病患儿的心肌酶谱及心电图变化。结果 全部肾病患儿均有明显的脂代谢紊乱 ,其血脂系列检查结果与正常对照组比较有极显著差异 ;14例肾病患儿的心肌酶谱及心电图 (ECG)均有不同程度的变化 ,其中肌酸磷酸激酶同功酶 (CK -MB)与总胆固醇(TC)、甘油三酯 (TG)、载脂蛋白B(ApoB)、脂蛋白 (a) [Lp(a) ]呈正相关 (P <0 .0 5 ) ,ECG异常与ApoB呈正相关(P <0 .0 5 )。结论 小儿肾病综合征时普遍存在脂代谢紊乱 ,以TC、ApoB、LDL、Lp(a)增高为著 ,对可引起冠心病的高危脂类成分的改变应引起重视
Objective To understand the characteristics of abnormal lipid metabolism in pediatric nephrotic syndrome (referred to as nephropathy). Methods Thirty patients with nephrotic disease, 30 children with acute nephritis and 20 children without liver and kidney disease were studied. The changes of myocardial enzymes and electrocardiogram in 14 children with nephropathy were observed. Results All children with renal disease had obvious lipid metabolism disorder. The result of blood lipid test showed significant difference compared with that of normal control group. The myocardial enzymes and ECG of 14 children with nephropathy had different degrees of change, of which, Creatine phosphokinase isoenzyme (CK-MB) was positively correlated with total cholesterol (TC), triglyceride (TG), apolipoprotein B (ApoB) and lipoprotein (a) 0. 05), ECG abnormalities were positively correlated with ApoB (P <0.05). Conclusion There is a general prevalence of dyslipidemia in children with nephrotic syndrome. The increase of TC, ApoB, LDL and Lp (a) is the most important cause of coronary heart disease.