2型糖尿病肾病患者血清脂蛋白(a)的水平变化及临床意义.DOCVIP

临床医学论文-2型糖尿病肾病患者血清脂蛋白(a)的水平变化及临床意义 ［摘要］ 目的：探讨血清脂蛋白(a)在2型糖尿病肾病中的临床意义。方法：根据24 h尿蛋白质排泄率(UAER)的测定结果，将121例糖尿病患者分为3组，糖尿病组(DM组)，早期糖尿病肾病组(EDN组)和临床糖尿病肾病组(CDN组)；51名健康者作对照组，分别测定各组血清总胆固醇(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)、脂蛋白(a)［Lp(a)］的水平，并对全部患者Lp(a)与尿UAER呈直线相关分析。结果：DM组Lp(a)水平高于对照组(P＜0.05)，EDN组及CDN组Lp(a)水平明显高于DM组，Lp(a)与UAER呈直线正相关(r=0.851 5，P＜0.01)。结论：血清Lp(a)水平升高与EDN进展有关，提示测定血清Lp(a)的水平可间接反映2型糖尿病的严重程度。 　　［关键词］ 2型糖尿病；糖尿病肾病；脂蛋白(a) 　　The Level Changes and Clinical Significance of Serum Lipoprotein (a) in Type 2 Diabetics Nephropathy 　　Abstract：Objective To evaluate the clinical significance of serum lipoprotein(a) in 2 type diabetics nephropathy．Methods According to the result of Urine Albumin measured for 24 hours,121 diabetic cases were devided into 3 groups,diabetic group(DM)，early diabetic nephropathy group(EDN)，clinical diabetic nephropathy group(CDN)；other 55 healthy persons were empolyed as control group.The levels of triglyceride(TG)、total cholesterol(TC)、high density lipoprotein cholesterol，HDLC、low density lipoprotein cholesterol(LDLC)、and lipoprotein(a) for all groups were tested,and all Lp(a)were analyzed with the correlated UAER in straightline.Results The Lp(a) levels of DM group were higher than control group(P0.05),the Lp(a) level in EDN group and CDN group was obviously higher than that in DM group,Lp(a) is positive correlated in straight line with UAER((r=0.851 5，P0.01).Conclusion Increased serum Lp(a) may be associated with the progression of EDN，It suggests that estimation of serum Lp(a) levels might reflect indirectly the degree of severity of diabetic nephropathy in 2 type diabetics. 　　Key words：Type 2 diabetes mellitus；Diabetic nephropathy；Lipoprotein(a) 　　糖尿病(Diabetics mellitus，DM)患者容易出现脂代谢异常，而脂代谢异常与糖尿病肾病(diabetic nephropathy，DN)的发生和发展密切相关。脂蛋白(a)［Lipoprotein(a)，Lp(a)］是动脉粥样硬化的独立危险因素，也是衡量肾脏疾病脂代谢紊乱的重要标志，Lp(a)升高与DM血管病变有密切关系，DN是DM常见的微血管并发症，常伴脂代谢紊乱，DM肾脏病变中，Lp(a)亦有升高［1］。DN是一种常见的DM慢性并发症，是DM患者致残和死亡的重要原因之一。国外研究表明，有近40%的终末期肾病患者为DM患者［2］，2型DM是终末期肾病的主要原因之一，国