肾脏疾病儿童血浆促酰化蛋白水平测定的意义  

Significance of Detection of Plasma Acylation Stimulating Protein Levels in Children with Renal Disease

作　　者：唐锦辉[1] 温宇[1] 王宏伟[1] Katherine Cianflone 米杰[3] 

机构地区：[1]华中科技大学同济医学院附属同济医院儿科,武汉430030 [2]加拿大拉瓦大学医学研究中心,加拿大魁比克市 [3]首都儿科研究所流行病学研究室,北京100020

出　　处：《实用儿科临床杂志》2008年第5期337-339,共3页Journal of Applied Clinical Pediatrics

基　　金：国家自然科学基金项目资助(30470645,30671804);国家自然科学基金对外合作与交流项目资助(30611120149);北京市科技计划重大项目资助(H030930030230)

摘　　要：目的探讨肾脏疾病儿童血浆促酰化蛋白(ASP)与血浆C3、非酯化脂肪酸(NEFA)及血脂的关系。方法肾脏疾病组48例,健康对照组279例。将48例肾脏疾病儿童分为3组:1.急性链球菌感染后肾小球肾炎(APSGN)组12例;2.狼疮性肾炎(LN)组4例;3.肾病综合征(NS)组32例。用ELISA方法检测各组血浆ASP水平,酶学比色法测定其NEFA水平,用酶学比浊法检测其血浆C3、血脂等生化指标。数据采用GraphPad Prism 4.0软件进行统计学分析。结果1.APSGN组(81.8±24.8)nmol/L、LN组(90.9±28.2)nmol/L和NS组(101.4±39.9)nmol/L血浆ASP水平明显高于健康对照组[(44.3±25.2)nmol/LPa<0.01];APSGN和LN组血浆C3水平均低于健康对照组(Pa<0.05),NS组与健康对照组比较C3无明显变化。2.肾脏疾病各组存在一定程度血脂代谢紊乱。APSGN组血浆三酰甘油(TG)水平高于健康对照组,但无统计学差异(P>0.05),而高密度脂蛋白胆固醇(HDL-C)显著低于健康对照组(P<0.001)。LN和NS组存在显著高TG、高TC和高低密度脂蛋白胆固醇(LDL-C)血症,LN组患儿还存在低血浆HDL-C水平(P<0.001),载脂蛋白(Apo)A和ApoB升高仅见于NS组(P<0.01,0.001);各组NEFA水平无显著变化。3.肾脏疾病患儿血浆ASP水平与TG(r=0.301P<0.05)、ApoA(r=0.307P<0.05)、C3(r=0.30P<0.03)均呈正相关。补体C3与TC(r=0.479P<0.001)、LDL-C(r=0.376P<0.01)、HDL-C(r=0.447P<0.01)、ApoA(r=0.551P<0.001)、ApoB(r=0.365P<0.01)均呈正相关。结论脂源性激素ASP和补体C3参与肾脏疾病患儿血脂代谢的调节。ASP的升高发生在严重血脂紊乱之前。Objective To estimate the plasma acylation - stimulating protein （ASP） and complement C3 levels in children with renal disease,and investigate the relationship among ASP, C3 and lipid levels. Methods Forty -eight protein uric renal disease children including 12 cases with acute post streptococcal infection glomerulonephritis （APSGN） ,4 cases with lupus nephritis （LN） , 32 cases with nephrotic syndrome（NS） and 279 age ,sex - matched healthy controls were included in this study. Enzyme.- linked immunosorbnent assay（ELISA） was employed to determine the plasma ASP concentration and plasma complement C3 level was detected by turbidimetry. Plasma non -esterified fatty acid was determined by colourimetric enzymatic assay and triglyceride was measured by glycerol phosphate oxidase coupled to phenol and 4 - aminophenazone method. Total cholesterol was analyzed by cholesterol oxidase coupled to phenol and 4 - aminophenazone method. High density lipoprotein - cholesterol （ HDL - C） concentration was determined using an enzymatic colourimetric assay after precipitation of apolipoprotein B （ApoB） -containing lipoproteins. Low density lipoprotein（LDL） was calculated by using the Friedwald formula [ LDL -C = TC - （TG/2.2） - HDL - C ]. For comparison of the differences among groups, One - Way ANOVA was used, followed by Bonferroni post - hoe test. Correlations between 2 parameters were calculated by using Pearson correlation. Results 1. Plasma ASP was significantly elevated in renal disease children [（81.8 ±24.8） nmol/L in APSGN group,（90.9 ±28.2） nmol/L in LN group,（101.4 ±39.9） nmol/L in NS vs （44.3 ± 25.2） nmol/L in control group Pa 〈0.01]. There was no alteration in C3 in children with NS [（1.05 ±0.28） vs （1.29 ±0.04） g/L P〉 0.05] ,while there was a decrease in C3 in children with LN and a compared with with compared to healthy control group[ （0.42 ±0. 11） vs （0.30 ± 0. 06） g/L Pa 〈 0. 05 ） ]. 2. Various aberrations in plasma lipids were note

关 键 词：促酰化蛋白 补体C 肾脏疾病 血脂 儿童 

分 类 号：R726.9[医药卫生—儿科]