【摘要】 目的探讨特发性膜性肾病（IMN）患者25-羟维生素D₃[25-（OH） D₃]水平及其与血脂的关系。方法检测109例初诊IMN患者治疗前的血清25-（OH） D₃及血脂水平,根据25-（OH） D₃水平将患者分为缺乏[25-（OH） D₃<25 nmol/L]组和不足[25-（OH） D₃≥25 nmol/L]组,分析25-（OH） D₃及其与血脂水平的关系。所有患者均补充维生素D,监测随访期间血清TC变化情况。结果入院时,109例IMN患者的25-（OH） D₃中位水平为12. 27（6. 79,24. 91） nmol/L,其中≥25 nmol/L共27例,<25 nmol/L共82例; 77. 98%（85/109）的患者合并高脂血症,以TC升高为主;不足组IMN患者TC、TG、LDL-C水平均高于缺乏组患者（均P <0. 05）; IMN患者25-（OH） D₃水平与TC、TG、LDL-C水平均呈负相关（均P <0. 05）。随访期间,不足组的TC水平总体呈下降趋势（P <0. 05）,但缺乏组中各时间点TC水平差异无统计学意义（P> 0. 05）。随访0、1、2个月时不足组的TC水平仍高于缺乏组（均P <0. 05）,但3～6个月时两组差异无统计学意义（P> 0. 05）。结论 IMN患者普遍存在25-（OH） D₃水平低下,25-（OH） D₃缺乏可能在IMN肾病血脂代谢紊乱的发生中起一定作用。补充维生素D或利于降低IMN患者血脂水平,从而控制病情。更多还原

【Abstract】 Objective To investigate 25-hydroxyvitamin D₃[25-（ OH） D₃]level and its relation with blood lipid in patients with idiopathic membranous nephropathy（ IMN）. Methods Serum 25-（ OH） D₃ and blood lipid levels were detected in 109 patients initially diagnosed as IMN before treatment,the patients were divided into deficiency group[25-（ OH） D₃< 25 nmol/L] and insufficiency group[25-（ OH） D₃≥25 nmol/L]according to their 25-（ OH） D₃ level,the relationship between 25-（ OH） D₃ level and blood lipid level was analyzed. All the patients were given vitamin D supplement,and changes in their serum TC were monitored during follow-up. Results Median 25-（ OH） D₃ level was12. 27（ 6. 79,24. 91） nmol/L in 109 IMN patients on admission,including 27 with 25-（ OH） D₃≥25 nmol/L and 82 with25-（ OH） D₃< 25 nmol/L. About 77. 98%（ 85/109） of the patients suffered from complication of hyperlipoidemia,the majority of them experienced elevated TG; IMN patients in the insufficiency group had higher levels of TC,TG and LDL-C compared with those in the deficiency group（ all P < 0. 05）. Among IMN patients,25-（ OH） D₃ level negatively correlated with TC,TG or LDL-C level（ all P < 0. 05）. During follow-up,TC level showed an overall decline in the insufficiency group（ P < 0. 05）,but in the deficiency group,no statistically significant difference was found in TC levels at various time points（ P > 0. 05）. TC levels at 0,1 and 2 months of follow-up remained higher in the insufficiency group compared with those in the deficiency group（ all P < 0. 05）,but no statistically significant difference was found between the two groups at 3-6 months of follow-up（ P > 0. 05）. Conclusion Decline of 25-（ OH） D₃ level is common in IMN patients,and 25-（ OH） D₃ deficiency probably plays a certain role in the development of blood-lipid metabolic disorder in IMN. Vitamin D supplement might be beneficial to decreasing blood lipid level of IMN patients,thus controlling the disease.更多还原