摘要
目的探讨原发性肾病综合征(PNS)患者血清脂蛋白a[Lp(a)]、骨形态发生蛋白-7(BMP-7)水平变化及其与预后的相关性。方法选取2015年2月-2018年6月我院收治的PNS患者76例作为PNS组,选择同期健康体检者50例作为对照组。PNS组患者均接受糖皮质激素联合环磷酰胺治疗,并于入院时和治疗6个月后检测24 h尿蛋白、肾功能指标、Lp(a)和BMP-7水平。比较PNS患者不同临床效果及不同复发情况患者的Lp(a)和BMP-7水平。结果 PNS组24 h尿蛋白、血肌酐(Scr)、尿素(BUN)及Lp(a)水平显著高于对照组,BMP-7水平显著低于对照组(P<0.05)。Lp(a)分别与PNS患者的24 h尿蛋白、SCr、BUN呈现正相关,BMP-7分别与PNS患者的24 h尿蛋白、SCr、BUN呈现负相关(P<0.01)。完全缓解PNS患者的Lp(a)水平显著低于部分缓解和未缓解患者,BMP-7水平显著高于部分缓解和未缓解患者(P<0.05)。治疗前和治疗后未复发PNS患者的Lp(a)水平显著低于复发患者,BMP-7水平显著高于复发患者(P<0.05)。结论在PNS患者中Lp(a)水平升高而BMP-7降低,高水平的Lp(a)和低水平的BMP-7与PNS更差的预后有关。
Objective To investigate the changes of serum lipoprotein a [Lp(a)] and bone morphogenetic protein-7(BMP-7) levels in patients with primary nephrotic syndrome(PNS) and their correlation with prognosis. Methods Seventy-six PNS patients admitted to our hospital from February 2015 to June 2018 were selected as PNS group, and 50 healthy people who underwent physical examination during the same period were selected as control group. All patients in PNS group were treated with glucocorticoid and cyclophosphamide, and 24 h urine protein, renal function index, LP(a) and BMP-7 were measured at admission and at 6 months after treatment. The levels of LP(a) and BMP-7 in PNS patients with different clinical effects and recurrence were compared. Results 24 h urine protein, serum creatinine(SCr), urea nitrogen(BUN) and LP(a) levels in PNS group were significantly higher than those in the control group, while BMP-7 levels were significantly lower than those in the control group(P<0.05). LP(a) was positively correlated with 24 h urinary protein, SCr and BUN in PNS patients, while BMP-7 was negatively correlated with 24 h urinary protein, SCr and BUN in PNS patients(P<0.05). The level of LP(a) in patients with complete remission was significantly lower than that in patients with partial remission and unresponsive PNS, and the level of BMP-7 was significantly higher than that in patients with partial remission and unresponsive PNS(P<0.01). Before and after treatment, the level of LP(a) was significantly lower and BMP-7 was significantly higher in patients without recurrent PNS, as compared with those in patients with recurrent PNS(P<0.05). Conclusion In patients with PNS, Lp(a) levels are elevated while BMP-7 are decreased, and high levels of Lp(a) and low levels of BMP-7 are associated with worse prognosis risk of PNS.
作者
李晓帆
周晓霜
李峻岭
赵海丹
LI Xiao-fan;ZHOU Xiao-shuang;LI Jun-ling;ZHAO Hai-dan(Department of Nephrology,Shougang Hospital of Peking University,Beijing 100041,China;Department of Nephrology,Shanxi Medical University,Taiyuan 030001,China)
出处
《解放军医药杂志》
CAS
2020年第5期62-65,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
国家自然科学基金青年基金(81600561)。
