降纤酶对肾病综合征患者血浆纤溶酶原激活物抑制剂1的影响

目的探讨纤溶酶原激活物抑制剂1(PAI-1)在原发肾病综合征患者血浆中的表达情况,PAI-1与临床检测指标有无相关性和应用降纤酶治疗后患者血浆中PAI-1水平的变化。方法选择62例原发性肾病综合征患者(肾病综合征组)及30例健康体检正常者(对照组),肾病综合征患者随机分为降纤酶组和非降纤酶组,采用酶联免疫吸附(ELISA)方法检测血浆中PAI-1水平,并分别在应用降纤酶前及应用降纤酶疗程结束后3 d、14 d、28 d分别检测血浆中PAI-1水平,并结合尿蛋白定量、血同型半胱氨酸、超敏C反应蛋白、血脂、纤维蛋白原水平进行统计学分析。结果肾病综合征组血浆PAI-1水平与对照组比较,差异有统计学意义(P<0.05);血浆PAI-1的表达与尿蛋白定量呈正相关(r=0.783,P<0.05),与同型半胱氨酸水平呈正相关(r=0.302,P<0.05);应用降纤酶治疗结束后3 d,14 d、28 d时血浆PAI-1水平比较,差异均有统计学意义(P<0.05)。两组治疗后不同时间血浆PAI-1水平与其治疗前比较,差异均有统计学意义(P<0.01)。结论肾病综合征患者血浆PAI-1的表达水平较正常人明显升高,与尿蛋白定量及同型半胱氨酸水平均呈正相关,PAI-1在肾脏病的发生、发展中起重要作用;应用降纤酶治疗后,能有效控制肾病综合征患者血浆中PAI-1水平,延缓肾脏病变进展。

Effects of Defibrase on Plasma PAI-1 in Patients with Nephrotic Syndrome

Objective To explore the expressionof plasminogen activator inhibitor-1(PAI-1) in plasma in patients sufferred from primary nephrotic syndrome,its relevance to clinical detection data and and the changes in PAI-1 level after treatment with defibrase.Methods 62 patients with primary nephrotic syndrome(Nephrotic Syndrome group) and 30 healthy people(control group)were chosen as the subjects.Nephrotic Syndrome group was randomly subgrouped into defibrase group,nondefibrase group.Use Enzyme-linked immunosorbent assay(ELISA) to detect the changes in PAI-1 levels in plasma in each group before and 3 days,14 days and 28 days after treatment with defibrase.Then statistical analysis was performed of the findings as well as urinary protein,homocysteine,hypersensitivity C-protein,levels of blood-fat and fibrinogen.Results There was a significant difference in PAI-1 level in plasma between Nephrotic Syndrome group and control group(P<0.05);PAI-1 in plasma was positively correlated with urinary protein(correlation coefficient is 0.783,P<0.05) and with the homocysteine(correlation coefficient is 0.302,P<0.05);the difference was also significant in plasma PAI-1 level between 3 days,14 days and 28 days after the treatment(P<0.05).A significant difference in plasma PAI-1 was also found at the same time before and after the treatment(P<0.01).Conclusion The plasma PAI-1 level in patients with nephrotic syndrome was higher than that in healthy persons,and was positively correlated with both urinary protein and homocysteine.Defibrase can regulate the level of PAI-1 in plasma,which played an important role in the occurrence and development of kidney diseases,thus delaying the progression of the diseases.