文章摘要
吕占柱 郑春喜 田润华△ 丁钰 韩斌 魏艳.原发性及狼疮性肾病综合征患者血清PAI-1、Lp(a)水平变化及其临床价值探讨[J].,2016,16(8):1509-1512
原发性及狼疮性肾病综合征患者血清PAI-1、Lp(a)水平变化及其临床价值探讨
The Changes and Clinical Values of SerumLipoprotein (a) and PlasminogenActivator Inhibitor-1 in Primary and Lupus Secondary Nephrotic Syndrome
  
DOI:
中文关键词: 血清脂蛋白a  纤溶酶原激活物抑制因子1  原发性肾病综合征  狼疮性肾病综合征
英文关键词: Lipoprotein (a)  Plasminogen activator inhibitor-1  Primary nephrotic syndrome  Lupus secondary nephrotic syndrome
基金项目:山东省科技发展计划项目(2012-YD-18037)
作者单位
吕占柱 郑春喜 田润华△ 丁钰 韩斌 魏艳 青岛大学医学院生物化学与分子生物学教研室青岛市商业职工医院检验科青岛大学附属医院检验科青岛大学医学院组织胚胎学教研室 
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中文摘要:
      目的:探讨原发性及狼疮性肾病综合征患者纤溶酶原激活物抑制因子1(PAI-1)和血清脂蛋白a[Lp(a)]的水平变化及其检测 的临床应用价值。方法:选取病理类型明确,临床初诊为肾病综合征的患者138例。其中原发性肾病综合征70 例,为PNS组;系统 性红斑狼疮继发性肾病综合征患者68 例,为LNS 组。同期选取本院健康体检正常者64 例,为正常对照NC 组。全自动生化分析 仪检测各组血清Lp(a)和血脂等指标;酶联免疫吸附(Elisa)法测定血清PAI-1 水平。结果:①与NC 组比较,血清Lp(a)和PAI-1 水 平在PNS和LNS 两组中均显著升高(P<0.05),PNS 组比LNS 组升高更为明显,差异有统计学意义(P<0.05);②LP(a)与PAI-1 秩相 关系数(rs)分析,在PNS 组中rs=0.328,P=0.006,LNS 组中rs=0.439,P=0.006;③二元logistic 回归分析表明,LP(a)和PAI-1 均是 PNS 和LNS的危险因素;④ROC 曲线分析表明,血清Lp (a)、PAI-1 对PNS 和LNS诊断的ROC曲线下面积(AUCROC) 分别为 0.895、0.874 和0.848、0.813,两者联合检测对PNS 和LNS诊断的AUCROC分别为0.947 和0.919。结论:血清Lp(a)与PAI-1 水平在 PNS 和LNS 患者体内均明显升高,PNS患者升高更为显著;Lp (a) 与PAI-1 水平在PNS 和LNS患者中均显著正相关;LP (a)和 PAI-1 均是PNS和LNS 的危险因素,两者水平的变化与PNS 和LNS的发生相关。联合检测Lp(a)与PAI-1 水平对PNS 和LNS的 诊治具有一定的临床应用价值。
英文摘要:
      Objective:To explore the levels and clinical values of serum lipoprotein (a) [Lp (a)] and plasminogen activator inhibitor-1 (PAI-1) in primary nephrotic syndrome (PNS) and lupus secondary nephrotic syndrome (LNS).Methods:138 nephrotic syndrome cases, including 70 PNS cases and 68 LNS cases whose renal pathological types were identified and 64 healthy physical examination people as normal controls (NC) in the same period were selected. Automatic biochemical analyzer detected the levels of serumLp(a) and blood lipids. Enzyme-linked immunosorbent (Elisa) method tested the concentration of serumPAI-1.Results:Compared with the NC group, Lp (a) and PAI-1 were increased obviously in both PNS and LNS groups (P<0.05). They were higher in PNS group than in LNS group (P<0.05). The rank correlation coefficient of PAI-1 and Lp (a) in the PNS group was 0.328 (P=0.006), and in LNS group was 0.439 (P=0.006); Logistic regression analysis results showed that Lp(a) and PAI-1 were two risk factors in both group PNS and LNS. The areas under the ROC curve (AUCROC) of Lp (a) and PAI-1 was 0.895 and 0.874 to PNS, and to LNS patients was 0.848 and 0.813 respectively. And the AUCROC of Lp (a) and PAI-1 combined detection to PNS and LNS was 0.947 and 0.919 respectively.Conclusion:Lp (a) and PAI-1 concentrations are increased obviously in both PNS and LNS patients, and they are higher in group PNS than in group LNS. Lp (a) and PAI-1 levels were significantly positively correlated in patients with PNS and LNS. They could be two risk factors in both PNS and LNS patients. The detection of themhas a higher clinical value in the diagnosis of PNS and LNS.
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