狼疮性肾炎中u—PA和PAI—1的表达及其意义

目的了解尿激酶型纤溶酶原激活物(u-PA)及其Ⅰ型抑制因子(PAI-1)在狼疮性肾炎(LN)肾小球病变中的表达及其意义。方法对50例不同类型的LN和10例原发性肾小球轻微病变的肾活检组织，采用免疫组化及图象分析法比较观察了u-PA和PAI-1在肾小球的表达强度，并与肾小球增殖细胞核抗原(PCNA)阳性细胞数和Ⅳ型胶原染色强度作相关分析。结果u-PA和PAI-1在各型LN病变肾小球中的表达，均比肾小球轻微病变明显增强(P<0.05或<0.01)，并以LN-IV型为最明显。PAI-1的染色反应强于同组的u-PA，两者有显著差异(P<0.05)。肾小球u-PA和PAI-1的表达均与PCNA阳性细胞核数呈正相关(P<0-05)。而且PAI-1的表达还与肾小球内IV型胶原沉积呈正相关(P<0.05)。结论狼疮性肾炎中u-PA和PAI-1的异常表达与肾小球的病变程度和病理类型相关，并可能是影响狼疮性肾炎发生发展的重要因素。

The expression and significance of u-PA and PAI-1 in human lupus nephritis

Objective To investigate the expression and significance of urokinase-type plasminogen activator (uPA) and type Ⅰ plasminogen activator inhibitor (PAI-1) in human lupus nephritis (LN). Method Immunohistochemistry and imaging analysis were used for detecting the intensity of expression of u-PA and PAI-1 in renal biopsied tissue of 50 cases with various types of LN and 10 cases with minor glomerular lesions (control group), the results were analyzed correlatively with PCNA cells and type IV collagen. Results The levels of u-PA and PAI-1 expression were different in various type of LN , in which, both were significantly higher than those of the minor glomerular lesion group (P＜0.05), and the highest was LN-IV group. The staining intensity of PAI-1 expression was significantly stronger than that of u-PA in various type of LN (P ＜0.05), the increased expression of u-PA and PAI-1 were positively correlated with increased number of PCNA + cell (P ＜0.05), while the expression of PAI-1 was also closely related to increased deposition of type IV collagen in the glomeruli ( P ＜0.05). Conclusion The abnormal expression of u-PA and PAI-1 were associated with the extent of injury and types of LN and may be one of important factor in contributing to the progression and inimry in LN. (Shanghai Med J, 2001,24:169)