肾病综合征患儿血清β_2-糖蛋白I/氧化低密度脂蛋白复合物水平升高的研究  

Elevated serum β_2-GPI/ox-LDL complexes levels in children with nephrotic syndrome

作　　者：黄中伟[1,2] 季茳[1] 牛冬梅[1] 罗阳[1] 蔡晓懿[3] 夏正坤[3] 杨玉华[4] 钟天鹰[4] 汪俊军[1] 张春妮[1] 

机构地区：[1]南京军区南京总医院临床检验科,南京210002 [2]溧水县人民医院检验科 [3]南京军区南京总医院儿科,南京210002 [4]南京市儿童医院检验科,南京210008

出　　处：《医学研究生学报》2013年第2期142-146,共5页Journal of Medical Postgraduates

基　　金：国家自然科学基金(30950100)

摘　　要：目的在血循环中氧化低密度脂蛋白(oxidized low density lipoprotein,ox-LDL)易与β2-糖蛋白I(β2-glycoproteinI,β2-GPI)结合成稳定的β2-GPI/ox-LDL复合物,该复合物是血栓形成和动脉粥样硬化(atherosclerosis,As)发生的新的危险因素。原发性小儿肾病综合征(nephritic syndrome,NS)患者伴有高脂血症和高氧化应急状态,具有肾小球硬化和血栓的危险性。文中检测NS患儿血清β2-GPI/ox-LDL复合物水平,分析其与NS病情的关系。方法以抗人β2-GPI抗体为包被抗体,酶标记抗载脂蛋白B(apo B)为检测抗体的血清β2-GPI/ox-LDL ELISA检测法,检测84例NS患儿和84例年龄、性别匹配的健康儿童(对照组)的血清。用ELISA法检测血清ox-LDL浓度,同时检测研究对象常规血脂水平和肾功能指标。结果 NS患儿血清β2-GPI/ox-LDL水平显著高于对照组[(1.08±0.47)U/ml vs(0.54±0.29)U/ml,P<0.001],ox-LDL浓度也明显升高[(143.76±64.55)mg/L vs(89.11±53.80)mg/L,P<0.01]。相关分析显示,β2-GPI/ox-LDL水平与ox-LDL(r=0.721)、LDL-C(r=0.518)、TC(r=0.503)、TG(r=0.380)以及尿蛋白(r=0.326)显著正相关(均为P<0.01),与血清清蛋白(Alb)显著负相关(r=-0.417,P<0.01)。进一步多因素分析显示,NS患儿β2-GPI/ox-LDL复合物水平49.5%的变化由ox-LDL(β=0.527,P<0.01)、尿蛋白(β=0.172,P=0.036)和LDL-C(β=0.203,P=0.037)决定。结论血清β2-GPI/ox-LDL水平升高与NS患儿病情有关。Objective Oxidized low density lipoprotein （ox-LDL） easily forms stable complex with β2-glycoprotein I （β2- GPI ） in circulation, which is regarded as a novel risk factor for thrombosis and atherosclerosis. Children with nephritic syndrome （NS） suffer from hyperlipidemia and increased oxidative stress. NS is associated with increased risk of glomerulosclerosis and thromboembo- lism. The aim of this study is to measure the serum concentrations of β2-GPI/ox-LDL complex and its correlation with childhood NS. Methods The concentrations of β2-GPI/ox-LDL complex wereexamined in 84 patients with NS and 84 age/sex-matched healthy controls by ELISA using rabbit anti-human 132-GPI antibody as the capture antibody, and quantitated with anti-apo （B） polyclonal antibody-enzyme conjugate. The concentrations of ox-LDL in serum were examined by ELISA, and the levels of serum lipids and kidney parameters were determined simultaneously. Results The con- centrations of serum 132-GPI/ox-LDL complex in children with NS were significantly higher than those in controls （ [ 1.08 ± 0.47 ] U/ml vs [ 0.54 ± 0.29 ] U/ml, P 〈 0.01 ）. Ox-LDL levels were also markedly elevated （ [ 143.76 ± 64.55 ] mg/L vs [ 89.11 ± 53.80 ] mg/L, P 〈0.01 ）. The concentrations of 132-GPI/ox-LDL were positively correlated with ox-LDL （ r = 0. 721 ）, LDL-C （ r = 0. 518 ）, total cholesterol （ r = 0. 503 ） and urine protein （ r = 0. 326） levels in children with NS （ P 〈 0.01 ）, while negatively related with serum albumin （Alb） in children with NS （r = - 0.417, P 〈 0.01 ）. Multiple linear regression analysis found the related change of ox-LDL （ 13 = 0. 527, P = 0.000）, urine protein （ 13 = 0. 172, P = 0. 036） and LDL-C （ 13 = 0. 203, P = 0. 037） accounted for 49.5 % of the variation in the change of 132＂GPI/ox-LDL- Conclusion The levels of 132-GPI/ox-LDL in serum complexes levels significantly elevat influenced by the condition of NS patients in NS patients, which may have a potential l

关 键 词：小儿肾病综合征 β2-糖蛋白I/氧化低密度脂蛋白复合物 氧化应激 病情 

分 类 号：R692[医药卫生—泌尿科学]