肾病综合征患者血浆中t-PA/PAI-1的变化及糖皮质激素治疗的影响

目的:探讨肾病综合征患者糖皮质激素治疗前后不同阶段组织型纤溶酶原激活物(t-PA)与纤溶酶原激活物抑制物-1(PA1-1)的变化.方法:分为健康对照组、肾病综合征组,采用酶联免疫吸附(ELISA)方法检测血浆中t-PA和PAI-1水平的变化.结果:t-PA的血浆水平在各组之间无统计学差异(P>0.05);PAI-1的水平在肾病综合征组较正常明显升高(P<0.05),激素治疗1周后进一步升高(P<0.05),治疗4周后比1周组有显著下降(P<0.05),但较正常仍高(P<0.05).结论:t-PA/PAI-1平衡的紊乱,可能参与了肾病综合征的损伤机制,经糖皮质激素治疗后高凝状态短期内无明显改善.

The Changes of Plasma t-PA/PAI-1 in Nephrotic Syndrome Patients and the Effects of Glucocorticoid

Objective:To investigate the changes of plasma levels of t-PA and PAI-1 in nephrotic syndrome patients and the effects of glucocorticoid on the balance of t-PA/PA-1.Methods:Patients were divided into groups of normal control, pre-treatment, 1 week post-treatment and 4 weeks post-treatment. ELISA was used to measure concentration of t-PA and PAI-1.Results:There was no significant difference in t-PA levels in different groups(P>0.05). The plasma level of PAI-1 in pre-treatment group was significantly higher than that of normal control(P<0.05).In the group of 1 week post-treatment, PAI-1 significantly increased compared to pre-treatment group(P<0.05).But in the group of 4 weeks post-treatment, the concentration of PAI-1 significantly decreased compared to the group of 1 week post-treatment(P<0.05). However, it was still higher than that of normal control(P<0.05).Conclusion:The disturbance of t-PA/PAI-1 balance may be implicated in renal damage of nephrotic syndrome, which can not be improved by glucocorticoid treatment in short time.