血脂异常在小儿原发性肾病综合征中的临床意义  

Clinical significance of dyslipidemia in children with primary nephrotic syndrome

作　　者：潘瑞英[1] Pan Ruiying(Department of Pediatrics,the 181th Hospital of PLA,Guilin 541002,China)

机构地区：[1]解放军第一八一医院儿科,广西壮族自治区桂林541002

出　　处：《中国实用医刊》2018年第22期18-20,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨血脂异常在小儿原发性肾病综合征中的临床意义。方法对2013年1月至2016年1月解放军第一八一医院收治的160例小儿原发性肾病综合征患儿的临床资料进行回顾性研究,分析血脂异常与肾毒性、高凝、低蛋白血症、24h尿蛋白排泄率的相关性,分析各临床分组与血脂异常的相关性。结果严重高脂血症与高脂血症的肾病综合征患儿比较,血浆白蛋白降低、纤维蛋白原升高、血肌酐升高,差异有统计学意义(P<0.05);各临床分组对血脂异常的影响不同,高凝组和凝血功能正常组总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)比较差异有统计学意义(P<0.05);中度、重度24h尿蛋白排泄率患儿TC较轻度蛋白尿组高,差异有统计学意义(P<0.05);初发组与复发组、肾功能正常组与肾功能异常组、感染组与非感染组TC、TG、高密度脂蛋白胆固醇(HDL-C)、LDLC比较,差异未见统计学意义(P>0.05)。结论机体的高凝状态会促进高脂血症的发生,中重度24h尿蛋白排泄率导致TC明显增高;严重的高脂血症与肾损害、高凝栓塞密切相关,临床中应积极控制蛋白尿排泄,特别加强高凝的治疗,有利于高脂血症的控制,延缓肾损害。ObjectiveTo investigate the clinical significance of lipid disorders in children with primary nephrotic syndrome.MethodsThe data of 160 cases of primary nephrotic syndrome in the 181th Hospital of PLA from January 2013 to January 2016 were retrospectively studied. The relationship between dyslipidemia and nephrotoxicity, hypercoagulability, hypoproteinemia, urinary protein excretion rate at 24 hours was analyzed. The relationship between the different clinical groups and lipid disorders was analyzed.ResultsSevere hyperlipidemia was compared with children with nephrotic syndrome with hyperlipidemia, the plasma albumin level was lower, the levels of fibrinogen and serum creatinine were higher, the differences were significant (P<0.05). The clinical groups had different effects on dyslipidemia, there were significant differences in TC, TG and LDL-C levels between hypercoagulable group and normal coagulation group (P<0.05). The TC level in patients with moderate and severe 24 hour urinary protein excretion rate was higher than that in mild proteinuria group (P<0.05). The TC, TG, HDL-C, LDLC in the first group and the recurrence group, the normal renal function group with abnormal group, infection group and non infection group were compared, the differences were not significant (P>0.05).ConclusionsHypercoagulable state of the body promotes the occurrence of hyperlipidemia, moderate to severe 24-hour urinary protein excretion rate leads to significantly increased TC; severe hyperlipidemia is closely correlated with renal damage, hypercoagulable embolism, clinicians should actively control proteinuria excretion, especially strengthen the treatment of hypercoagulability, which is conducive to the control of hyperlipidemia, delay renal damage.

关 键 词：小儿肾病综合征 血脂异常 高凝 肾损害 

分 类 号：R726.9[医药卫生—儿科]