过敏性紫癜肾儿童血尿纤溶酶原激活物及其抑制物的变化及干预治疗

目的　探讨过敏性紫癜肾患儿外周血和尿液中组织型纤溶酶原激活物 (tPA)及 1型纤溶酶原激活物抑制物 (PAI 1)的活性和尿纤溶酶原激活物总活性 (PAs)的变化特点及予血管紧张素转化酶抑制剂 (ACEI)、低分子肝素治疗的影响。方法　 2 3例紫癜肾儿童为研究对象 ,11名正常对照。分别于ACEI和低分子肝素治疗前、治疗后 1周、治疗后 2周取血、尿标本 ,用纤维平板法测定尿PAs活性 ,用酶联免疫吸附测定 (ELISA)法测定血tPA和PAI 1活性 ,以 x±s报道数据。 结果　紫癜肾患儿于治疗前血tPA水平和尿PAs总活性均明显低于正常对照组 ,而PAI 1水平则显著高于对照组 ,ACEI和肝素联合治疗后 ,随着治疗的持续可明显改善凝血纤溶系统平衡紊乱的趋势 (P <0 0 1)。结论　紫癜肾儿童血、尿凝血纤溶系统平衡紊乱 ,表现为凝血亢进和纤溶障碍 ,干预性治疗具有一定疗效

Changes of tissue-type plasminogen activator and its inhibitor in blood and urine in children with Henoch-Schnlein purpura nephritis and effects of interfering treatment

Objective To investigate the changes of tissue-type plasminogen activator (tPA) and 1-type plasminogen activator inhibitor (PAI-1) in blood and the total activity of plasminogen activators (PAs) in urine in children with Henoch-Sch*inlein purpura nephritis (HSPN),and the interfering effects of ACEI and low-molecular heparin therapy.Methods The subjects were 23 HSPN children,and 11 normal children as control group.The blood and urine samples were collected at different times before and after treatment,the blood tPA and PAI-1 were detected by ELISA,and urinary total activity of PAs by fibrinogen plate method.Results The blood tPA level and urinary PAs activity decreased markedly,but the PAI-1 increased in the children with HSPN.There disorders were ameliorated significantly following the treatment of ACEI and heparin (P<0.01).Conclusion The unbalance of thrombo-fibrinolytic system appeared in HSPN.Elevated levels of PAI-1 and lowered levels of tPA can reduce the function of endogenous fibrinolytic system.Interfering treatment can prevent or quell those disturbances.