过敏性紫癜患儿血浆血栓调节蛋白血管性假血友病因子基质金属蛋白酶-9的检测及临床意义  

Determination and clinical significance of TM、vWF、MMP-9 in children with Henoch-Schonlein purpura

作　　者：蔡维艳[1] 李爱敏[1] 李春香[1] 王璇[1] 

机构地区：[1]青岛大学医学院附属烟台毓璜顶医院儿内科,山东烟台264000

出　　处：《中国实用儿科杂志》2007年第10期770-772,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的检测过敏性紫癜(HSP)患儿血浆血栓调节蛋白(TM)、血管性假血友病因子(vWF)、基质金属蛋白酶-9(MMP-9)水平,探讨它们在HSP发病机制中的作用及与紫癜性肾炎(HSPN)的关系。方法2006-09—2007-02在青岛大学医学院附属烟台毓璜顶医院儿内科住院的HSP患儿46例,应用酶联免疫吸附试验(ELISA)检测HSP患儿急性期(46例)、缓解期(40例)及健康对照儿童(20例)血浆TM、vWF、MMP-9水平。结果HSP患儿急性期TM、vWF、MMP-9水平明显高于对照组(P均<0.01),也高于缓解组(P均<0.05)。MMP-9下降较缓慢,在恢复期仍显著高于对照组(P=0.01)。伴肾受累组vWF、MMP-9高于非肾受累组(P均<0.05),而TM在两组之间差异无显著性意义(P>0.05)。TM、vWF浓度之间成直线正相关,而TM、vWF分别与MMP-9之间相关性分析无统计学意义。结论血管内皮细胞及细胞外基质损伤在HSP的发病机制中起着重要的作用,血浆TM、vWF、MMP-9水平测定有助于了解病情活动及判断是否合并肾脏损害,动态测定有助于观察病情演变及指导治疗。Objective To investigate the role of plasma thrombomodulin （ TM ） ,von willebrand factor （ vWF ） and matrix metalloproteinase-9 （ MMp-9 ） in children with Henoch-Schonlein purpura （ HSP ）. Methods The plasma concentrations of TM,vWF,MMP-9 were measured by enzyme-linked immunosorbent assay （ ELISA） method in 46 acute SHP patients, 40 recovery patients and 20 healthy controls. Results The plasma levels of TM,vWF,MMP-9 in acute phase were significantly higher than those in healthy controls（ P 〈0. 01 ） and higher than those during recovery period. The plasma levels of MMP-9 for the SHP patients dropped back slowly and their levels during recovery period were still higher than those in healthy controls （ P =0.01 ）. The plasma levels of TM,MMP-9 were higher in renal damage group than in non-renal damage group （ P 〈 0. 05 ）. whereas the plasma levels of TM had no significant difference between them （ P 〉 0. 05 ）. The plasma levels of TM showed positive correlation with the level of vWF. But The plasma levels of TM and vWF showed no correlation with the level of MMP-9. Conclusion The damage of vascular endothelium and extracellular matrix plays an important role in the pathological mechanism of HSP. The levels of plasma TM,vWF,MMP-9 may be used as indexes of the HSP activity and progression.

关 键 词：过敏性紫癜 血栓调节蛋白 血管性假血友病因子 基质金属蛋白酶-9 

分 类 号：R72[医药卫生—儿科]