紫癜性肾炎患儿血清基质金属蛋白酶-2、-9及其组织抑制因子-1水平及比值变化的意义

目的探讨基质金属蛋白酶-2、-9(MMP-2、-9)及其组织抑制因子-1(TIMP-1)水平及比值变化在紫癜性肾炎(HSPN)发病机制中作用及与尿微量清蛋白(MA)的相关性。方法采用双抗体夹心ABC-ELISA法对36例单纯紫瘢、16例HSPN患儿进行血清MMP-2、-9和TIMP-1水平检测,免疫散射速率比浊法进行尿MA水平检测。与30例健康儿童对照。结果过敏性紫癜(HSP)患儿急性期血清MMP-2、-9和TIMP-1水平及MMP-2、-9/TIMP-1比值均增高,且HSPN组高于单纯紫癜组,单纯紫癜组高于健康对照组,组间差异具有显著性意义(P<0.01或<0.05)。MMP-2、-9、TIMP-1水平及比值与尿MA水平呈明显正相关(r=0·736,0.726,0·581Pa<0.01)。且尿MA异常组(Ⅱ)较正常组(Ⅰ)增高更明显,组间比较有显著性差异(P<0.01或0.05)。结论MMP-2、-9、TIMP-1水平升高及比值失衡参与HSPN的发病过程,并与尿MA形成呈正相关。

Significance of Changes of Serum Levels and Ratios of Matrix Nephritis Metalloproteinase-2,-9 and Tissue Inhibitor of Metalloproteinase-1 in Children with Henoch-Schonlein Purpura Nephristis

Objective To explore the effect of levels and ratios of matrix nephritis metalloproteinase-2(MMP-2), -9 and inhibitor of metalloproeinase-1(TIMP-1) in the pathogenesis of children with Henoch-Schonlein purpura nephritis(HSPN),and the correlation between them and urinary micro albumin(MA).Methods Serum levels of MMP-2, -9 and TIMP-1 were determined by double antibody enzyme linked immunosorbent assay(ELISA),and urine MA was determined by immune rate nephelometry in 36 children with HSPN,16 children with simple purpura and 30 healthy controls.Results Levels of MMP-2, -9,TIMP-1 and ratios of MMP-2/ TIMP-1,MMP-9/TIMP-1 rose in acute phase of HSPN. The levels and ratios in HSPN group were higher than those in simple purpura group,and those in simple purpura group higher than those in controls (P<0.01 or <0.05). Levels of MMP-2, -9,TIMP-1 and ratios of MMP-2/ TIMP-1,MMP-9/ TIMP-1 positively correlated to level of urinary MA.The correlation coefficients(r) were 0.736,0.726 and 0.581,respectively,Pa<0.01.The increase in group with abnormal urinary MA was higher than that in group with normal urinary MA.The difference was significant (P<0.01 or 0.05).Conclusion The high levels and unbalanced ratios of MMP-2, -9 and TIMP-1 take part in the pathogenesis of HSPN and they positively correlate to level of urinary MA.