慢性肾脏病患者血浆血管性血友病因子裂解酶活性测定  

Alteration of the Plasma vWF-CP Activity in Chronic Kidney Disease Patients

作　　者：刘金霞[1] 胡坤[1] 卢国元[1] 王兆钺[2] 苏健[2] 阮长耿[2] 

机构地区：[1]苏州大学附属第一医院肾内科,江苏苏州215006 [2]江苏省血液研究所,卫生部血栓与止血重点实验室,江苏苏州215006

出　　处：《中国血液流变学杂志》2009年第4期503-505,512,共4页Chinese Journal of Hemorheology

基　　金：国家自然科学资金资助项目（30670904）

摘　　要：目的检测慢性肾脏病（CKD）患者血浆血管性血友病因子裂解酶（vWF-CP）活性及血浆血管性血友病因子（vWF）水平，探讨其在慢性肾脏病的意义。方法将139例CKD患者根据不同种类肾病及不同肾功能状态分组，其中狼疮肾炎（LN）31例，原发性肾病综合征（NS）25例，糖尿病肾病（DN）45例及慢性肾炎（CGN）38例；CKDⅠ期38例，CKDⅡ期30例，CKDⅢ期39例，CKDⅣ期19例，CKDⅤ期13例。采用残余胶原结合实验法及ELISA法对患者血浆vWF-CP活性及vWF水平进行检测，观察不同组患者血浆vWF-CP活性及vWF水平，并与正常对照组（40名）比较。结果LN、NS、DN及CGN患者血浆vWF-CP活性显著低于对照组，且以LN、NS组下降最明显，vWF水平均显著高于正常对照组，血浆vWF含量均与血浆vWF-CP活性呈负相关。CKDⅡ期、Ⅲ期血浆vWF-CP活性显著低于Ⅰ、Ⅳ、Ⅴ期．而Ⅰ、Ⅳ、Ⅴ期之间无显著区别，vWF含量各期之间无显著差别。结论CKD患者血浆vWF-CP活性明显降低，其低下程度与肾病的病种有关。内皮损伤、自身抗体可能是致CKD患者vWF-CP活性低下的原因之一。它参与了CKD的发生发展，可能是CKD血栓形成的机理之一。Objective To investigate the change of the plasma von Willebrand factor cleaving protease（vWF-CP） activity and yon Willebrand factor（vWF） level in chronic kidney disease（CKD） and to study the clinical significance.Methods Forty healthy subjects and 139 patients with CKD enrolled in this study.Plasma vWF-cp activity and vWF level was measured by residual-collagen binding assay（R-CBA） and ELISA.CKD patients were further divided into subgroups according to different types of kidney disease and different stages of renal function the group of 31 patients with lupus nephritis（LN）,25 with primary nephritic syndrome（NS）, 45 with diabetic nephropathy（DN）,38 with chronic glomerulonephritis（CGN）;38 with the stage Ⅰ of CKD,30 with the stage Ⅱ,39 with the stage Ⅲ,19 with the stage Ⅳ,13 with the stage Ⅴ .Results The vWF-CP activity in LN, NS, DN and CGN patients was significantly lower than that in the normal control （P〈0.01）, which was more remarkable in LN, NS groups.The level of the vWF was significantly higher than that of normal control（P〈0.01）,the stages Ⅱ and Ⅲ of the CKD was significantly lower than that of in the stages Ⅰ ,Ⅳ and Ⅴ of CKD. The alteration degree of vWF level was not different among the five stages.Conclusion The level of the plasma vWF-CP activity is associated with the CKD and reflect the different types. The injury of endothelial cells and autoantibodies against vWF-CP activity may be ones of the factors that resulted in lower vWF-CP activity in the CKD patients, which may be one of the mechanisms of CKD progress and thrombosis.

关 键 词：慢性肾脏病 血管性血友病因子 血管性血友病因子裂解酶 残余胶原结合实验 

分 类 号：R692[医药卫生—泌尿科学]