【摘要】 目的探讨特发性难治性局灶节段性肾小球硬化(FSGS)患者脂蛋白a[Lp(a)]、低密度脂蛋白胆固醇(LDL-C)、转化生长因子β1(TGF-β1)水平与疗效的相关性。方法回顾性分析134例特发性FSGS患者,根据治疗4个月时尿蛋白定量、肾功能及血清白蛋白情况分为难治组64例和激素敏感组70例,分析足量激素治疗前,治疗2、4、6个月时血清胆固醇(CHO)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、LDL-C、Lp(a)和TGF-β1水平。结果特发性FSGS难治组和FSGS激素敏感组的血清Lp(a)、TGF-β1、LDL-C均明显高于正常范围,难治组Lp(a)和TGF-β1高于激素敏感组,差异有统计学意义(P<0.05);难治组LDL-C较激素敏感组升高,但差异无统计学意义(P>0.05)。经足量激素治疗4个月后,激素敏感组Lp(a)、TGF-β1、LDL-C较治疗前均明显下降,差异有统计学意义(P<0.05)。难治组Lp(a)、TGF-β1、LDL-C较治疗前无明显变化,差异无统计学意义(P>0.05)。结论特发性FSGS存在Lp(a)、TGF-β1的代谢紊乱,同时其升高程度可作为特发性难治性FSGS早期判定指标,早期联合其他治疗方案,减少激素不良反应。更多还原

【Abstract】 Objective To investigate the relationship between plasma transforming growth factor-β1(TGF-β1),low density lipoprotein cholesterol(LDL-C)and lipoprotein(a)[Lp(a)]in focal segmental glomerulosclerosis(FSGS).Methods A total of 134 patients were enrolled in this cross-sectional study.According to urinary protein,renal function and plasma protein after enough prednisone treatment for 4months,patients were divided into 64 cases as difficulty group and70 cases as sensitive group.Level of TGF-β1,LDL-C and Lp(a)were analyzed before and 2,4,6months after treatment among different groups.Results Level of plasma Lp(a),TGF-β1and LDL-C were higher than normal in both groups.Lp(a)and TGF-β1in difficulty group were higher than those in sensitive group(P<0.05).Level of plasma LDL-C was not significant(P>0.05).After treatment with enough prednisone for 4months,Lp(a),TGF-β1and LDL-C were lower in sensitive group than before(P<0.05).Another group was not significant(P>0.05).Conclusion Level of plasma Lp(a),TGF-β1was disordered in FSGS.They can be used as early marker in difficulty group.更多还原