Clinical Evaluation And Significance Of The Plasma Lipoprotein (a) [(Lp(a))] In Children With The Primary Nephrotic Syndrome

Objective To explore plasma lipoprotein(a)[(Lp(a))]change and influence factor in children with nephrotic syndrome,evaluate the correlation between the change of lipoprotein(a)[(Lp(a))] and albumn,the reaction to the steroid.Method 52 cases children were our hospital patients,steroid-sensitive group consisted of 32 cases,steroid-insensitive group consisted of 20 cases and 20 cases healthy children were used as control group,plasma lipid were determined by enzyme methods,lipoprotein(a)[(Lp(a))]level was determined by enzyme-linked immunosorbent assay(ELISA),and according to the level of 24 hours Urine protein were determined by proteingel electrophoresis,15 children with Microalbuminuria(0.15～0.5g/24h),10 children with light-range Urine protein(0.5～1g/24h),31 children with midrange Urine protein(1～3.5g/24h),10 children with heavy-range Urine protein(＞3.5g/24h).prothrombin time(PT),fibrinogen(FIR),activated partial thromboplastin time(APTT) were determined by clotting method.Results 1 The level of plasma TC,TG,HDL-C,LDL-C,ApoA,ApoB,PT,APTT,FIR,TP,A of steroid-sensitive nephritic syndrome and steroid-insensitive nephritic syndrome apparent difference with normal control,lipoprotein(a)[(Lp(a))]significant deviation between the steroid-sensitive nephritic syndrome(203.19±154.83mg/L) and the steroid-insensitive nephritic syndrome(613.20±200.73mg/L),p＜0.01.2 Lipoprotein(a)[(Lp(a))]of the steroid-sensitive nephritic syndrome had uncorrelation with plasma-albumin,Lipoprotein(a)[(Lp(a))]of the steroid-insensitive had negative correlation with plasma-albumin,coefficient correlation of r=0.526.3 Lipoprotein(a)[(Lp(a))]significant deviation between the heavy-range Urine protein group(489.69±305.03 mg/L) and the Microalbuminuria group(138.00±76.47 mg/L),p＜0.01, 4 Lipoprotein(a)[(Lp(a))]of the Microalbuminuria group and light-range Urine protein group and midrange Urine protein group had uncorrelation with plasma-albumin, Lipoprotein(a)[(Lp(a))]of the heavy-range Urine protein group had negative correlation with plasma-albumin,coefficient correlation r=0.652.Conclusions 1 The plasma lipid and coagulation in nephritic syndrome of children was abnormality,High lipoprotein(a)[(Lp(a))]Lp(a) may predict the sensitive of steroid.2 High Lp(a) may predict the degree of albuminuria.