慢性肾脏病患者血脂变化及其与血清骨保护素、甲状旁腺激素的关系研究  

Serum Lipid Changes in Patients with Chronic Kidney Disease and Its Relationship with Osteoprotegerin and Parathyroid Hormone

作　　者：陈高翔[1] 张峰[2] 黄德芳[3] 张松[3] 杜渊[1] 李春庆[1] 

机构地区：[1]江苏省无锡市第三人民医院肾脏内科,214041 [2]江苏省无锡市第三人民医院检验科,214041 [3]江苏省无锡市第三人民医院内分泌科,214041

出　　处：《中国全科医学》2011年第34期3940-3942,共3页Chinese General Practice

摘　　要：目的探讨慢性肾脏病(CKD)患者血清骨保护素(OPG)、全段甲状旁腺激素(iPTH)、血脂变化的临床意义以及相互之间的关系。方法采用酶联免疫吸附法(ELISA法)测定100例不同分期的慢性肾脏病患者以及25例健康体检者的OPG、iPTH和血脂水平。结果慢性肾脏病4、5期(内生肌酐清除率<30 ml/min)的脂蛋白-a(Lp-a)水平升高,与对照组比较差异有统计学意义(P<0.05)。慢性肾脏病各期患者与对照组间血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白A1(ApoA1)比较,差异均无统计学意义(P>0.05)。慢性肾脏病3、4、5期患者的血清OPG水平显著高于对照组,差异有统计学意义(P<0.05);慢性肾脏病4、5期患者的血清iPTH水平明显高于对照组,差异有统计学意义(P<0.05)。相关分析表明,OPG、iPTH与Lp-a呈正相关(P<0.05)。结论慢性肾脏病患者的OPG和iPTH与Lp-a相关,提示OPG、Lp-a可能共同参与肾功能不全患者的血管损伤。Objective To investigate the clinical significances of changes of serum lipids,osteoprotegerin（OPG） and serum intact parathyroid hormone（iPTH） in patients with chronic kidney disease（CKD）,as well as their relationships among them. Methods The serum concentrations of OPG and iPTH in 25 normal subjects and 100 CKD patients were measured by using enzyme linked immunosorbent assay（ELISA）. Results Compared with the control group,serum level of lipoproteinα（Lp-a） increased significantly in CKD patients at 4,5 stage（endogenous creatinine clearance rate〈30 ml/min）（P〈0.05）.There were no statistically significant differences between the CKD patients at each stage and the control in total cholesterol（TC）,triglyceride（TG）,low density lipoprotein-cholesterol（LDL-C）,high density lipoprotein-cholesterol（HDL-C）,and apolipoprotein A1（ApoA1）（P〉0.05）.The serum concentrations of OPG in CKD patients at 3,4,5 stage were significantly higher than those of the controls（P〈0.05）.The serum concentrations of iPTH in CKD patients at 4,5 stage were significantly higher than those of the controls（P〈0.05）.The correlation analysis showed that OPG and iPTH were positively correlated with Lp-a（P〈0.05）. Conclusion The serum levels of OPG and iPTH are correlated with Lp-a level in CKD patients,which indicates OPG and Lp-a may jointly contributes to the vessel impairment in renal function insufficiency.

关 键 词：慢性肾脏病 血脂 骨保护素 甲状旁腺激素 

分 类 号：R692[医药卫生—泌尿科学]