原发性肾病综合征(PNS)患儿血清NEFA/ALB比值的变化

目的:观察初发及缓解原发性肾病综合征(PNS)患儿血清NEFA/ ALB 比值的变化,为临床PNS 的诊断及病情评估提供新指标。方法:对52 例PNS 急性期患儿、34 例PNS 缓解期患儿和50 例健康儿童的血清白蛋白(ALB)、游离脂肪酸(NEFA)、尿素氮(BUN)、尿酸(UA)、肌酐(Scr)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平进行定量分析,并对NEFA/ ALB 比值与其他生化指标进行相关性分析。结果:与正常对照组相比,急性组和缓解组患儿血清ALB、HDL-C 水平均显著降低(P< 0.05),而急性组患儿血清NEFA/ ALB、TC、TG、LDL-C、UA 显著升高(P< 0.05);缓解组患儿仅TG、LDL-C 显著升高(P< 0.05)。与缓解组相比,急性组患儿血清ALB 水平显著降低(P <0.05),而血清NEFA/ ALB、TC、TG、LDL-C、UA、BUN、Scr 水平均显著升高(P< 0.05)。将血清生化指标比较中差异有统计学意义的指标与NEFA/ ALB 比值进行相关分析,结果显示NEFA/ ALB 比值与TC、TG、LDL-C、UA、BUN 呈显著正相关性(P 均<0.05),与ALB 呈显著负相关性(P< 0.05)。多元线性逐步回归分析结果显示,血清NEFA/ ALB 比值与BUN 独立相关(β=0.045,t =1.602,P =0.003)。结论:在PNS 疾病发生和发展过程中,NEFA/ ALB 比值升高预示患儿的肾脏功能损伤加重或肾功能降低,对其进行监测有助于临床病情评估与判断。

Study on changes of ratio of serum NEFA / ALB in children with primary nephrotic syndrome

Objective:To study on the changes of the ratio of serum NEFA/ ALB in children with primary nephrotic syndrome,and to provide new indicators for the diagnosis and severity assessment of clinical PNS.Methods: The levels of serum albumin(ALB),free fatty acid (NEFA),urea nitrogen(BUN),uric acid(UA),creatinine(Scr),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C) were quantitatively measured in 52 patients with PNS in acute stage (acute stage group) and 34 patients with PNS in complete remission (remission stage group) and 50 healthy children(control group).The lipid/ lipoprotein and renal function parameters were also analyzed.Results: Compared with controls group,the levels of serum ALB,HDL-C in acute group and remission group decreased significantly (P< 0.05),but the levels of serum NEFA/ ALB,TC,TG,LDL-C,UA,BUN,Scr in acute group increased significantly (P< 0.05),the levels of serum TG,LDL-C in acute group increased significantly (P<0.05). Compared with remission group,the levels of serum ALB in acute group decreased significantly (P< 0.05),but the levels of serum NEFA/ALB,TC,TG,LDL-C,UA,BUN,Scr increased significantly (P< 0.05).In PNS children,the ratio of NEFA to ALB was positively correlated with the levels of TC,TG,LDL-C,UA,BUN (P< 0.05),while negatively correlated with ALB(P< 0.05).Multiple linear regression analysis showed that the ratio of NEFA to ALB had an independent association with BUN levels(β=0.045,t =1.602,P =0.003).Conclusion: In the development process of PNS disease,serum ratio of NEFA to ALB increased indicates impaired kidney function or reduced kidney function,and it can help doctor assess and judge the clinical condition.