慢性肾脏疾病血清和尿液纤溶活性物质的改变及临床意义

目的探讨慢性肾脏疾病血清和尿液纤溶活性物质的改变及其临床意义。方法选择38例慢性肾小球肾炎(CGN),28例肾病综合征(NS),36例非透析治疗的慢性肾功能不全(CRF)和20例正常对照作为研究对象,应用ELISA法检测血清和尿液中组织型纤溶酶原激活剂(t-PA)和纤溶酶原激活物抑制剂-1(PAI-1)的浓度,同时分析尿中t-PA和PAI-1的水平与血t-PA、PAI-1、血肌酐和24h尿蛋白总量之间相关性。结果慢性肾脏疾病出现血清t-PA、PAI-1升高,尿液t-PA、PAI-1降低,其中尿液t-PA、PAI-1的改变独立于血清,不受血肌酐和24h尿蛋白定量的影响。结论慢性肾脏疾病患者存在纤溶活性物质的异常,其中尿液纤溶活性物质的改变可反应肾脏内皮细胞损伤。

Changes of Serum and Urinary Plasminogen Activator and Clinical Significance in Patients with Chronic Kidney Diseases

Objective To explore the clinical changes and diagnostic significance of serum and urinary plasminogen activators in patients with chronic kidney diseases.Methods The level of serum and urinary tissue-type plasminogen activator(t-PA)and plasminogen activator inhibitor-1(PAI-1)were measured in 38 patients with chronic glomerulonephritis,28 patients with nephropathy syndrome,36 patients with chronic renal failure and 20 healthy subjects by means of enzyme-linked immunosorbent assary.The relationship among urinary t-PA,PAI-1 and serum t-PA,PAI-1,urinary protein,serum creatinine were also observed.Results Levels of serum t-PA,PAI-1 in chronic kidney diseases increased remarkably compared with control group.Levels of urinary t-PA,PAI-1 in chronic kidney diseases decreased remarkably compared with control group.There was no positive correlation between urinary t-PA,PAI-1 and serum t-PA,PAI-1,urinary protein and serum creatinine.Conclusion There was remarkable abnormality of plasminogen activators in patients with chronic kidney diseases.Changes of urinary plasminogen activators can reflect endothelial damage of kidney.