2型糖尿病肾病患者血清脂蛋白(a)水平变化及临床意义.doc

2型糖尿病肾病患者血清脂蛋白(a)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(Plt;0.05),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，Plt;0.01).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，国内2型