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[肾病综合征中的脂尿]

[Lipiduria in the nephrotic syndrome].

作者信息

Neverov N I, Nikitina E A

出版信息

Ter Arkh. 1992;64(6):16-8.

PMID:1440328
Abstract

A study was made of urine lipids and their fractions in chronic glomerulonephritis (CGN) and renal amyloidosis with nephrotic syndrome (NS). 91 patients suffering from NS were examined. 2 subgroups were distinguished among these patients: with CGN of the nephrotic type and with the nephrotic stage of renal amyloidosis. The reference groups were made up of patients with latent CGN and healthy subjects. Measurements were made in the blood and urine of total lipids (TL) and their fractions--phospholipids (LP), free cholesterol (FC), mono- and diglycerides, triglycerides (TG), and cholesterol esters (CE). The presence of the NS was attended by a rise in the blood of TL concentration, relative content of FC, TG and by a decline of RL and CE, with the decrease of the relative content being more manifest in amyloidosis. Nephrotic lipiduria was largely characterized by an increase of the concentration of TL and of the relative content of PL, with the changes of the latter parameter being mostly characteristic of CGN patients. Thus, NS was associated with a high excretion of lipids with urine which is likely to reflect their elevated filtration under nephrotic hyperlipidemia. Still, in nephropathies whose pathogenesis is determined by an important role of inflammatory and membrane-destructive processes, of definite role is also the local (renal) formation of PL.

摘要

对患有慢性肾小球肾炎(CGN)和肾淀粉样变性伴肾病综合征(NS)患者的尿脂质及其组分进行了一项研究。对91例患有肾病综合征的患者进行了检查。在这些患者中区分出2个亚组:肾病型慢性肾小球肾炎患者和肾淀粉样变性肾病期患者。参照组由隐匿性慢性肾小球肾炎患者和健康受试者组成。对血液和尿液中的总脂质(TL)及其组分——磷脂(LP)、游离胆固醇(FC)、单甘油酯和二甘油酯、甘油三酯(TG)和胆固醇酯(CE)进行了测量。肾病综合征的存在伴随着血液中总脂质浓度、游离胆固醇和甘油三酯相对含量的升高以及磷脂和胆固醇酯的降低,其中相对含量的降低在淀粉样变性中更为明显。肾病性脂尿在很大程度上表现为总脂质浓度和磷脂相对含量的增加,后一参数的变化在慢性肾小球肾炎患者中最为典型。因此,肾病综合征与尿液中脂质的高排泄有关,这可能反映了肾病性高脂血症时脂质滤过增加。然而,在发病机制由炎症和膜破坏过程起重要作用所决定的肾病中,磷脂的局部(肾脏)形成也具有一定作用。

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