慢性肾小球肾炎患者血浆纤溶酶原激活物及其受体和纤溶酶原激活物抑制剂的变化与干预研究  

Plasma Concentration Changes and the Clinical Significance of Plasminogen Activator,Plasminogen Activator Receptor and Plasminogen Activator Inhibitor-1 in Patients with Chronic Glomerulonephritis and the Intervenient Research on Them

作　　者：夏阳波[1] 卢国元[1] 熊佩华[1] 谢燕[1] 沈蕾[1] 

机构地区：[1]苏州大学附属第一医院肾内科,江苏苏州215006

出　　处：《苏州大学学报（医学版）》2007年第1期105-107,共3页Suzhou University Journal of Medical Science

摘　　要：目的探讨慢性肾小球肾炎血浆纤溶酶原激活物及其受体和纤溶酶原激活物抑制剂(PAI-1)的变化意义,血管紧张素转换酶抑制剂(ACEI)治疗的干预影响。方法测定78例慢性肾小球肾炎患者的血浆组织型纤溶酶原激活物(tPA)、尿激酶型纤溶酶原激活物(uPA)及其受体(uPAR)和PAI-1的水平,与健康成年人43人作对照;并观察经ACEI治疗8周后各项指标的改变。结果78例患者血浆uPAR水平明显高于对照组(P<0.05),PAI-1水平显著高于对照组(P<0.01)。予以ACEI(福辛普利)10～20mg/d治疗8周后,ACEI治疗组患者PAI-1水平较常规治疗组患者明显下降(P<0.05)。结论慢性肾小球肾炎患者血浆PAI-1水平明显升高,细胞外基质(ECM)的转化受到抑制;ACEI治疗可降低PAI-1水平,促进ECM的转归,延缓肾脏纤维化。Objective To explore the plasma concentration changes of tissue-type plasminogen activator（tPA）, urokinasetype plasminogen activator（uPA）, urokinasetype plasminogen activator receptor （uPAR） and plasminogen activator inhibitor-1 （PAI-1）. in chronic glomerulonephritis （CGN） and the effect of the angiotension converting enzyme inhibitor（ACEI）. Methods The plasma tPA, uPA and PAI-1 levels in CGN patients（ n = 78） and normal controls（ n = 40） were assayed. These indices in CGN patients have been observed after treatment with ACEI （monopril, 10 - 20 mg per day for 8 weeks） Results The plasma concentration of uPAR increased obviously in the CGN patients compared with that in the healthy people （ P 〈 0.05） . The plasma concentration of PAI-1 increased obviously in the CGN patients compared with that in the healthy people（ P 〈 0.01）. The plasma concentration of PAI-1 decreased obviously in the CGN patients who received the treatment of ACEI after treatment for 8 weeks, compared with that in the CGN patients who did not received such treatment（ P 〈 0.05）. Conclusion The plasma concentration of PAI-1 increases obviously in the CGN patients so that the turnover of extracellular matrix （ECM） is inhibited. Meanwhile the treatment of ACEI can accelerate the turnover of ECM by decreasing the plasmic concentration of PAl-1, so as to retard renal fibrosis.

关 键 词：慢性肾小球肾炎 组织型纤溶酶原激活物 尿激酶型纤溶酶原激活物 尿激酶型纤溶酶原激活物受体 1型纤溶酶原激活物抑制剂 血管紧张素转换酶抑制剂 

分 类 号：R692.31[医药卫生—泌尿科学]