| Objective:To analyze the influence on relapse made by hyperlipidemia during remission in primary nephrotic syndrome(PNS).Methods:1.From 2013 to 2015,the patients with primary nephrotic syndrome in adults and adolescents who were diagnosed and treated by the Department of Nephrology,the First Affiliated Hospital of Nanhua University were studied.According to whether the blood lipid level is greater than The 95 th percentile of blood lipids in matched healthy subjects on the age and gender,the objects were divided into two groups: the dyslipidemia during remission group and the normal group,Corresponding to the experimental group and the control group.The clinical characteristics of the two groups were collected by consulting the electronic case system or reading the paper case data.The factors affecting the dyslipidemia during remission were investigated by single factor comparison and multivariate regression analysis.2.Prognosis follow-up was performed on the included subjects.The follow-up period was 3 years.The prognostic event in this study was PNS relapse.The differences in prognostic events between the two groups and subgroups were statistically compared.Finally,Spearman correlation analysis was used to correlate prognostic events with duration of dyslipidemia.Results:1.A total of 105 subjects were enrolled.There were 51 patients with hyperlipidemia during remission and 54 patients with normal lipids during remission.There were no significant differences in age,gender,initial cholesterol level,low-density lipoprotein level,high-density lipoprotein level,serum albumin level,and hormone use between the two groups(P>0.05).Initial triglyceride levels,urinary protein quantification,the status of initial phase,use of statins and use of immunosuppressants were significantly different(P<0.05);multivariate logistic regression analysis showed use of statins was the independent protection factor(OR=0.243,95%CI:0.096~0.614,P<0.01).2.103 subjects were finally included in the prognosis analysis,including 24 patients with relapse.In the experimental group(N=51),19 patients relapsed while 32 patients were not,and the rate of relapse was 37.9%.In the control group(N=52),5 patients relapsed,51 patients were not,which had a relapse rate of 9.6%.The prognostic conditions were significantly different between the two groups(P<0.05);the experimental group was more likely to relapse;that is,patients with hyperlipidemia during remission were more likely to relapse.3.In the TC abnormal group(N=47),19 patients relapsed,28 patients were not,and the rate of relapse was 40.4%.In the normal group of TC(N=56),5 patients had relapsed while 51 patients were not.The relapse rate was 8.9%.There were significant differences in the prognosis between them(P<0.05).In the TG abnormal group(N=36),7 patients had relapsed,29 patients were not,and the rate of relapse was 19.4%.In the normal TG group(N=67),17 patients had relapsed,50 patients were not,and the rate of relapse was 25.4%.There were no significant differences in the TG abnormalities between the prognosis(P>0.05).In summary,patients with TC abnormalities during remission were more likely to relapse.4.In the statin group(N=67),11 patients relapsed,56 patients were not,and the relapse rate was 16.4%.In the group without statin(N=36),there were 13 patients relapsed,23 patients were not,with a relapse rate of 36.1%.There were significant differences in the prognosis between the use of statins(P<0.05);patients with statins were more likely to reduce NS relapse.5.In the hyperlipidemia during NS remission group,the prognosis rank was significantly positively correlated with hyperlipidemia time(P<0.05,Rs=0.522).Conclusion:1.Persistent hyperlipidemia during remission,especially serum total cholesterol abnormalities,can be considered as a predictor of relapse in primary nephrotic syndrome.2.There is hyperlipidemia during remission period in PNS,and use of statins was the independent protection factor,thereby reducing the relapse of primary nephrotic syndrome. |
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