纤溶活性与D二聚体变化在高血压肾小动脉硬化症发病中作用研究

目的 :了解纤溶活性和血、尿 D二聚体 (D- d)水平变化在高血压肾小动脉硬化症 (HANS)中作用。方法 :采用 EL ISA法测定血、尿 D- d,用发色底物法测定纤溶酶 (p:A)、组织型纤溶酶原激活剂 (tp A:A )及纤溶酶原抑制剂活性 (PAI:A) ,并同时测定尿白蛋白量 (放免法 )和尿乙酰葡糖苷酶 (NAG,光电比色法 )。结果 :原发性高血压 (EH)组及 HANS组较正常对照组 ,p:A和 t Pa:A明显降低 ,PAI:A和血、尿 D- d水平显著升高 ;HANS组与 EH组比较 ,血浆 PAI:A、尿 D- d、尿白蛋白和NAG排泄水平均明显升高 ;另外 ,PAI:A/ t Pa:A或尿 D- d/血 D- d值与尿 NAG、白蛋白排泄量都有明显正相关关系。结论 :纤溶活性和血、尿 D二聚体水平变化在高血压肾小动脉硬化的发生发展中具有重要作用 ,可作为早期诊断的依据

Significance of Changes of Fibrinolytic Activity And D0-dimer Level in Benign Arteriolar Nephrosclerosis Due to Primary Hypertention.

Aim:To investigate the relation of changes of plasma fibrino lytic activity and D dimer level with hypertensive arteriolar nephrosclerosis(HANS). Methods:To determine p:A, tpA:A and PAI: A using color substrate , and to measure plasma or urine D dimer using ELISA. Results:Both the EH group and the HANS group had significantly lower p:A and tpA:A, and higher PAI:A ,plsama and urine D dimer level compared with normal subject group; The HANS group had markedly higher level of plasma PAI:A , urine D dimer , urine albumin and urine trans N acetylglucosaminidase(NAG) excretion than that of the EH group. There was a positive linear correlation of PAI:A/tpA:A or urine D d/plasma D d ratios with urine NAG and urine albumin excretion. Conclusions:Abnormalities of fibrinolytic activity and D d level play an important role in hypertensive arteriolar nephrosclerosis and can be used as indicator for early diagnosis.