尿激酶受体在血栓性疾病中的表达及临床意义

目的：检测尿激酶型纤溶酶原激活物受体(u—PAR)在阵发性睡眠性血红蛋白尿(PNH)患和心肌梗死、脑梗死患中的表达，并探讨其临床意义。方法：PNH组22例，其它血栓形成组20例，其中心肌梗死10例，脑梗死10例，健康对照组20例。以流式细胞术检测外周血白细胞上u—PAR的表达，BLISA法检测血清su—PAR。结果：健康对照组外周血粒细胞中u—PAR^ 细胞比例皆＞90％，其它血栓形成组与健康对照组表达率无显性差异。PNH患外周血粒细胞u—PAR^ 细胞显降低，与其它两组相比，有显性差异。其它血栓形成组和健康对照组血清su-PAR水平较低，范围较窄，而PNH组血清su-PAR水平显升高，且离散度较大，与另两组有显性差异。PNH伴血栓形成su—PAR水平显升高。PNH患中血栓阳性组与血栓阴性组比较，外周血粒细胞u—PAR表达率明显降低，血清su—PAR水平显升高，均有显性差异。PNH患血清su-PAR与u—PAR^ 细胞百分率呈负相关。结论：PNH患外周血粒细胞u-PAR表达率降低，血清su-PAR水平明显增高，与血栓形成并发症相关。以流式细胞术检测细胞u—PAR并检测血清su—PAR有助于监测PNH患血栓形成。

Study on the Expression of Urokinase-type Plasminogen Activator Receptor in Thrombotic Patients and its Clinical Implications

Objective:To investigate the expression of urokinase-type plasrninogen activator receptor (u-PAR) on the peripheral blood granulocytes and soluble u-PAR(su-PAR) ,myocardial infarction and cerebral infarction, and its clinical implications. Methods: A total of 22 PNH patients, 20 other thrombotic patients, including 10 petients with myocerdial infarction and 10 pctiants with carebrel to infarction, and 20 healthy controls. The expression of u-PAR on peripheral blood granulocytes were analyzed with flow cytometry. Soluble u-PAR (su-PAR) in serum was assayed by enzyme-linked immunoadsorbent assay (ELISA) . Results: All the fraction of u-PAR+ granulocytes in the peripheral blood from 20 healthy controls were more than 90% . No remarkable difference was found between the expressions of u-PAR in thrombotic patients and healthy controls. The expression of u-PAR in 22 PNH patients was significantly decreased and the level of serum su-PAR was increased with a greater variation, especially in the patients with thrombosis. In the 22 PNH patients, the expression of u-PRA was significantly decreased and the serum level of su-PAR was significantly elevated in thrombotic patients compared with nonthrombotic patients. The serum level of su-PAR was negatively correlated to the percentage of u-PAR+ granulocytes in PNH patients. Conclusion: In PNH patients, the expression of u-PAR on granulocytes was remarkably decreased and the serum level of su-PAR was increased significantly. Flow cytometric analysis of u-PAR on the peripheral blood granulocytes and detection of su-PAR were of value in monitoring thrombosis in PNH patients.