慢性肾炎患者血清TIMP-1浓度的变化及氯沙坦治疗对TIMP-1浓度的影响

目的探讨慢性肾炎患者血清金属蛋白酶组织抑制因子-1 (tissue inhibitor of metalloproteinase-1,TIMP-1)浓度的变化及意义,并观察氯沙坦治疗对TIMP-1浓度的影响。方法以酶联免疫吸附试验检测45例慢性肾炎患者及10例健康志愿者血清TIMP-1浓度,分析其与肾组织纤维化程度的相关性;并将慢性肾炎患者分为2组,治疗组25例,在常规治疗的基础上加用氯沙坦,对照组20例,单用常规治疗,观察治疗前后血清TIMP-1浓度的变化,进行对照分析。结果慢性肾炎患者血清TIMP-1浓度较正常显著增高;血清TIMP-1浓度与肾组织纤维化程度呈正相关。氯沙坦治疗组在改善肾功能、降低尿蛋白及血清TIMP-1浓度方面明显好于对照组。结论血清TIMP-1浓度可反映慢性肾炎患者肾脏纤维化程度,氯沙坦治疗能显著降低慢性肾炎患者血清TIMP-1浓度,提示氯沙坦可通过调节金属蛋白酶活性,从而减缓肾脏纤维化。

Serum TIMP-1 concentration in patients with chronic glomerulonephritis and the effect of losartan

Objective To elucidate the significance of the changes in serum tissue inhibitor of metalloproteinase-1(TIMP-1) in patients with chronic nephritis, and investigate the changes of TIMP-1 concentrations after losartan therapy. Methods Serum TIMP-1 concentrations were measured by enzyme-linked immunosorbent assay (ELISA) in 45 patients with chronic nephritis and 10 healthy volunteers respectively, and the relationship between serum TIMP-1 concentration and the degree of renal fi-brosis was investigated. The changes of serum TIMP-1 concentrations in patients after losartan therapy were measured in comparison with those of patients without losartan therapy. Results Serum TIMP-1 concentration in patients with chronic nephritis was significantly higher than that in healthy subjects, and tended to exacerbate the glomerulosclerosis and interstitial fibrosis. Losartan therapy could improve the patients' renal functions, decrease the levels of urine protein and serum TIMP-1. Conclusions Serum TIMP-1 concentration was in close correlation with the degree of renal fibrosis. Losartan therapy could decrease serum TIMP-1 levels, indicating that losartan may slow down the progression of renal fibrosis by regulating the ac-tivity of metalloproteinases.