原发性肾病综合征高脂血症发生机制的研究进展*

摘要：原发性肾病综合征高脂血症主要表现为血浆总胆固醇（Ch）和低密度脂蛋白胆固醇（LDL-Ch）明显升高，甘油三酯（TG）和极低密度脂蛋白胆固醇（VLDL-Ch）升高。高密度脂蛋白胆固醇（HDL-Ch）浓度可降低或不变，但HDL的亚型分布异常，即HDL3 增加而HDL2 减少。这提示我们HDL3 转变为富含CH的HDL2 成熟障碍。不过，关于高脂血症在肾病综合征的发生机制较为复杂，还不十分清楚。但是目前有关该机制的观点主要集中在（1）低白蛋白血症刺激肝脏合成胆固醇、甘油三酯、脂蛋白增加，（2）外周脂蛋白的清除障碍，（3）高密度脂蛋白（HDL）的成熟障碍，本文就此做一综述。

Reserch Progeress for the Mechanismof Hyperlipidemiain Primary Nephrotic Syndrome*

ABSTRACT:The hyperlipidemia in patients with primary nephrotic syndrome are strikingly elevated concentrations of plasma totalcholesterol (Ch) and low density lipoprotein cholesterol (LDL-Ch), triglyceride (TG) and very low density lipoprotein cholesterol (VLDL-Ch). The high density lipoprotein cholesterol (HDL-Ch) levels are reported to be unchanged or reduced. In addition, maturation fromHDL3 into HDL2 is impaired and leads to a significant elevation of HDL3 and a marked reduction in HDL2. The mechanism ofhyperlipidemia in nephrotic syndrome is a very complicated process that even today remains unclear. Three major mechanisms couldinduce hyperlipidemia:(1) hypoalbuminemia may lead to increase in the synthesis of albumin and other proteins by the liver, includinglipoproteins (2) decreased catabolism of lipoprotein (3)abnormalities of high density lipoprotein (HDL) maturation and metabolism. Thispaper summarizes this differences.