2型糖尿病患者血清脂蛋白（a）检测的临床意义

探讨2型糖尿病血清脂蛋白（a）[Lp（a）]水平及其变化的临床意义。方法：采用免疫透射比浊法测定了20例正常人、20例冠心病患者和70例2型糖尿病（DM）患者的血清Lp（a）水平，综合考虑其血清尿素氮（BUN）、肌酐（CRE）、尿微量白蛋白（mAlb）水平，将70例2型糖尿病患者分为2组：2型糖尿病无肾病组40例（BUN＜7．30mmol／L，CRE＜105μmol／L，mAtb＜11．7mg/L），糖尿病肾病（DN）组30例（BUN＞7．30mmol／L，CRE＞105μmol／L）。结果：正常人和2型糖尿病无DN组间血清LP（a）水平差异无显著性（P＞0．05）；糖尿病肾病组Lp（a）水平显著升高（P＜0．05），这一点与冠心病患者相似。2型糖尿病患者中，血清Lp（a）水平与mAlb呈简单正相关关系（r=0．03，P＜0．05），多元线性回归分析显示，mAlb未能进入多元回归方程？结论：2型糖尿病患者无DN时，血清Lp（a）水平与非糖尿病患者相比差异无显著性；2型糖尿病合并DN患者出现血清Lp（a）水平显著增高，且与尿微量白蛋白呈正相关关系，提示Lp（a）水平升高可能继发于DN的肾脏损害，随肾脏损害进展而逐步升高。

A Study of Lipoprotein（a） Levels in Type 2 Diabetes Mellitus Patients

ZHANG Jian, GUAN Qi, WANG Rui （Department of Clinical Laboratory, Fengtian Hospital Affiliated to Shenyang Medical College, Shenyang 110024, China）

Abstract:

Objective：To investigate the serum Lipoprotein（a）[ Lp（a）] level in type 2 diabetes mellitus and sense of alternative. Methods：Serum Lp（a） concentration was measured in 20 normal person,20 coronary heart disease patients and 2 group of type 2 diabetes mellitus patients including 40 without diabetes nephritis（DN）（BUN 〈 7.30 mmol/L, CRE 〈 105 μmol/L, mAlb 〈 11.7 mg/L） ;30 patients with DN （BUN 〉 7.30mmol/L, CRE 〉 105 μmol/L）. Serum Lp（a） concentration in every patient groups were compared with that in normal person. Result：Lp（a） levels were similar between type 2 diabetes mellitus patients without DN and natural person. But in patients with DN,Lp（a） level significantly increased as compared with above-mentioned two groups, this is like the coronary heart disease patients. There was a positive correlation between Lp（ a ） concentration and mAlb （ r = 0. 03, P 〈 0. 05 ）. Conclusion： Lp（a） levels might be normal in type 2 diabetes mellitus patients without DN, but it could increase in type 2 diabetes mellitus patients with DN and might be related with renal impairment.

Key words:

lipoprotein（a） ; type 2 diabetes mellitus; diabete nephropathy