目的探讨肾脏疾病儿童血浆促酰化蛋白(ASP)与血浆C3、非酯化脂肪酸(NEFA)及血脂的关系。方法肾脏疾病组48例,健康对照组279例。将48例肾脏疾病儿童分为3组:1.急性链球菌感染后肾小球肾炎(APSGN)组12例;2.狼疮性肾炎(LN)组4例;3.肾病综合征(NS)组32例。用ELISA方法检测各组血浆ASP水平,酶学比色法测定其NEFA水平,用酶学比浊法检测其血浆C3、血脂等生化指标。数据采用GraphPad Prism 4.0软件进行统计学分析。结果1.APSGN组(81.8±24.8)nmol/L、LN组(90.9±28.2)nmol/L和NS组(101.4±39.9)nmol/L血浆ASP水平明显高于健康对照组[(44.3±25.2)nmol/LPa<0.01];APSGN和LN组血浆C3水平均低于健康对照组(Pa<0.05),NS组与健康对照组比较C3无明显变化。2.肾脏疾病各组存在一定程度血脂代谢紊乱。APSGN组血浆三酰甘油(TG)水平高于健康对照组,但无统计学差异(P>0.05),而高密度脂蛋白胆固醇(HDL-C)显著低于健康对照组(P<0.001)。LN和NS组存在显著高TG、高TC和高低密度脂蛋白胆固醇(LDL-C)血症,LN组患儿还存在低血浆HDL-C水平(P<0.001),载脂蛋白(Apo)A和ApoB升高仅见于NS组(P<0.01,0.001);各组NEFA水平无显著变化。3.肾脏疾病患儿血浆ASP水平与TG(r=0.301P<0.05)、ApoA(r=0.307P<0.05)、C3(r=0.30P<0.03)均呈正相关。补体C3与TC(r=0.479P<0.001)、LDL-C(r=0.376P<0.01)、HDL-C(r=0.447P<0.01)、ApoA(r=0.551P<0.001)、ApoB(r=0.365P<0.01)均呈正相关。结论脂源性激素ASP和补体C3参与肾脏疾病患儿血脂代谢的调节。ASP的升高发生在严重血脂紊乱之前。 Objective To investigate the relationship between plasma acyl-stimulating protein (ASP) and plasma C3, non-esterified fatty acid (NEFA) and blood lipids in children with kidney disease. Methods 48 cases of kidney disease group, 279 cases of healthy control group. Forty-eight children with renal disease were divided into three groups: 1. 12 cases of acute streptococcal glomerulonephritis (APSGN) group, 2 cases of lupus nephritis (LN) group, 4 cases of nephrotic syndrome (NS) group 32 cases. Plasma ASP levels were measured by ELISA, NEFA levels were measured by enzyme-linked immunosorbent assay, and biochemical parameters such as plasma C3 and blood lipid were detected by enzyme-turbidimetry. Data were statistically analyzed using GraphPad Prism 4.0 software. Plasma ASP levels in the APSGN group (81.8 ± 24.8) nmol / L, LN group (90.9 ± 28.2) nmol / L and NS group (101.4 ± 39.9) nmol / L were significantly higher than those in the healthy control group [(44.3 ± 25.2) nmol / LPa <0.01]. The levels of plasma C3 in APSGN and LN groups were lower than those in healthy controls (P <0.05). There was no significant change in C3 between NS group and healthy controls. 2. There is a certain degree of renal dysfunction in each group dyslipidemia. The level of triglyceride (TG) in APSGN group was higher than that in healthy control group, but there was no significant difference (P> 0.05), while the level of HDL-C in APSGN group was significantly lower than that in healthy control group (P <0.001). LN and NS group had significant high TG, high TC and high and low density lipoprotein cholesterol (LDL-C). There were also low plasma HDL-C level (P <0.001), apolipoprotein (Apo) A and ApoB increased only seen in the NS group (P <0.01,0.001); NEFA levels in each group had no significant change. The level of plasma ASP in children with renal disease was positively correlated with TG (r = 0.301P <0.05), ApoA (r = 0.307P <0.05) and C3 (r = 0.30P <0.03). The levels of complement C3 and TC (r = 0.479P <0.001), LDL-C (r = 0.376P <0.01), HDL-C (r = 0.447P <0.01), ApoA = 0.365P <0.01) were positively correlated. Conclusion The adipogenic ASP and complement C3 are involved in the regulation of blood lipid metabolism in children with renal diseases. Elevated ASP occurs before severe dyslipidemia.