【摘要】：目的:腎病綜合征(nephrotie syndrome,NS)是兒科臨床上常見的腎臟疾病,發(fā)病率僅次于急性腎炎,患兒除腎臟本身病變外,高脂血癥等也可導(dǎo)致心血管系統(tǒng)并發(fā)癥。本文通過對我科收治的部分患兒的回顧性研究,分析血清膽紅素在原發(fā)性腎病綜合征患兒(primary nephrotie syndrome,PNS)體內(nèi)的變化,并進一步分析引起膽紅素變化的原因及意義。方法:收集山西醫(yī)科大學(xué)第一醫(yī)院兒科自2008年9月到2016年4月確診的PNS患兒49例為腎病組,急性腎小球腎炎患兒30例為對照組;收集的臨床資料包括血清總膽紅素(total bilirubin,TBIL)、直接膽紅素(direct bilirubin,DBIL)、間接膽紅素(indirect bilirubin,IBIL),總膽固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG),血白蛋白(albumin,ALB)及24h尿蛋白定量(24h urine proteinquantitation,24h Upr);應(yīng)用SPSS17.0軟件分析兩組間膽紅素差異及膽紅素與血脂、24h Upr的關(guān)系。結(jié)果:(1)腎病組血清中TBIL、IBIL低于對照組;兩組比較差異有統(tǒng)計學(xué)意義(P0.05);血清DBIL與對照組比較差異無統(tǒng)計學(xué)意義。(2)腎病組患兒按血脂正常和異常分為兩組(TC、TG兩項均在正常范圍內(nèi)即為血脂正常組),比較兩組間膽紅素的差異,血脂偏高組TBIL水平低于血脂正常組,兩組間膽紅素差異有統(tǒng)計學(xué)意義(P0.05)。血脂與膽紅素經(jīng)相關(guān)性分析無正負相關(guān)性。(3)腎病組TBIL與24h Upr經(jīng)相關(guān)性分析(按血脂正常與異常),血脂正常組(P0.01;r=-0.517)無相關(guān)性;血脂異常組(P0.01;r=-0.562)呈負相關(guān)。結(jié)論:(1)NS患兒體內(nèi)膽紅素水平較對照組降低。(2)分析腎病組膽紅素降低的原因,將NS患者依血脂正常和異常分組,血脂正常組膽紅素高于血脂異常組,膽紅素參與血脂代謝,可能對NS患兒心血管系統(tǒng)并發(fā)癥的預(yù)防及治療提供新的思路。(3)腎病組TBIL與24h Upr呈負相關(guān)(血脂異常組),血脂與膽紅素?zé)o負相關(guān)性,提示血清低膽紅素血癥可能與大量蛋白尿?qū)е履懠t素隨尿液流失有關(guān)。
[Abstract]:Objective: nephrotie syndrome (NS) is a common renal disease in pediatrics, the incidence of which is second only to acute nephritis. The changes of serum bilirubin in children with primary nephrotic syndrome (primary nephrotie syndrome) were analyzed retrospectively, and the causes and significance of the changes in bilirubin were analyzed. Methods: 49 children with PNS and 30 children with acute glomerulonephritis were collected from September 2008 to April 2016 in the first Hospital of Shanxi Medical University. Clinical data collected included total bilirubin (TB), direct bilirubin (DBIL), indirect bilirubin (IBIL), total cholesterol (TC), triglyceride (TG), serum albumin (Albumin) and 24 h urine protein (24 h Upr);). The relationship between serum lipids and serum bilirubin and 24 h Upr. Results: (1) Serum TBILIBIL in nephropathy group was lower than that in control group. The difference between the two groups was statistically significant (P0.05), and there was no significant difference between the serum DBIL and the control group. (2) the children in the nephropathy group were divided into two groups according to the normal blood lipid and abnormal blood lipids. The difference of bilirubin, The level of TBIL in hyperlipidemia group was lower than that in normal blood lipid group, and the difference of bilirubin between the two groups was statistically significant (P0.05). There was no positive or negative correlation between serum lipids and bilirubin. (3) in nephropathy group, there was no correlation between TBIL and 24 h Upr (according to normal and abnormal blood lipids), but there was no correlation between normal blood lipid group (P0.01r-0.517), and negative correlation was found in dyslipidemia group (P0.01r-0.562). Conclusion: (1) the level of bilirubin in NS group is lower than that in control group. (2) analyze the reason of bilirubin decrease in nephropathy group, group NS patients according to normal and abnormal blood lipids, bilirubin in normal blood lipid group is higher than that in dyslipidemia group, bilirubin is involved in lipid metabolism. It may provide a new idea for the prevention and treatment of cardiovascular complications in NS children. (3) in nephropathy group, TBIL is negatively correlated with 24 h Upr (dyslipidemia group), and there is no negative correlation between lipid and bilirubin. The results suggest that serum hypobilirubinemia may be related to the loss of bilirubin with urine loss caused by large amount of proteinuria.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R726.9

【參考文獻】

相關(guān)期刊論文 前2條

1 王明翠;劉麗丹;謝永新;劉征;李安均;;血清膽紅素水平與腎病綜合征關(guān)系的Meta分析[J];標記免疫分析與臨床;2015年11期

2 中華醫(yī)學(xué)會兒科學(xué)分會腎臟病學(xué)組 ,姚勇,楊霽云 ,陳述枚 ,丁潔;小兒腎小球疾病的臨床分類、診斷及治療[J];中華兒科雜志;2001年12期

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