慢性肾病患者血浆vWF与vWF裂解酶的检测及临床意义  

Detection and significance of plasma vWF and vWF-CP activity in patients with chronic renal diseases

作　　者：胡坤[1] 刘金霞[1] 卢国元[1] 王兆钺 苏健 阮长耿 

机构地区：[1]苏州大学附属第一医院肾脏病科,215006 [2]江苏省血液研究所

出　　处：《江苏医药》2010年第4期373-376,共4页Jiangsu Medical Journal

基　　金：国家自然科学资金资助(30470732)

摘　　要：目的探讨慢性肾脏病(CKD)患者血浆血管性血友病因子(vWF)水平及vWF裂解酶(vWF-CP)活性检测及其在CKD中的临床意义。方法31例狼疮肾炎(LN组)、45例糖尿病肾病(DN组)、25例原发性肾病综合征(NS组)、38例慢性肾炎(CGN组)患者及40例正常对照者(NC组),采用残余胶原结合实验法及ELISA法检测血浆vWF-CP活性及vWF水平,并分析不同病理类型、不同肾功能状态下两项指标的改变。结果4组CKD患者血浆vWF水平均显著高于NC组(P<0.01),vWF-CP活性显著低于NC组(P<0.01);其中,LN、NS组下降最明显;CKD患者vWF含量与vWF-CP活性显著负相关。CKDⅡ、Ⅲ期vWF-CP活性显著低于Ⅰ、Ⅳ、Ⅴ期(P<0.05)。行肾活检患者中,LN患者Ⅳ型vWF显著高于Ⅱ型、Ⅲ型,而vWF-CP活性显著低于Ⅱ型、Ⅲ型。膜性肾炎(MN)vWF-CP活性显著低于微小病变肾病(MCD)、系膜增生性肾炎(MsPGN)和IgA肾病(IgAGN)(P<0.05)。经综合治疗8周后,vWF水平显著下降,vWF-CP活性水平在治疗后SLEDAI评分<9分者有显著性升高(P<0.05)。结论CKD患者血浆vWF升高,vWF-CP活性低下程度与肾病的病种有关,反映了病理类型的轻重。Objective To evaluate the detection and significance of von Willebrand factor（vWF）and vWF-cleaving protase（vWF-CP）activity in patients with chronic renal diseases（CKD）.Methods vWF and vWF-CP activity were measured using ELISA and residual-collagen binding assay（R-CBA）,respectively,in 31 patients with lupus nephritis（group LN）,25 cases with primary nephritic syndrome（group NS）,45 cases with diabetic nephropathy（group DN）,38 cases with chronic glomerulonephritis（group CGN）and 40 normal controls（group NC）.The relation of their levels with pathological and renal status was analyzed.Results vWF was higher and vWF-CP activity was lower significantly in groups of LN,NS,DN and CGN than those in group NC（P0.01）,which was the most in groups of LN and NS.The change of vWF was negatively correlated to that of vWF-CP.The plasma vWF-CP activity in the stages of Ⅱ and Ⅲ of the CKD was significantly lower than that in the stages of Ⅰ,Ⅳ and Ⅴ of the CKD（P0.05）.vWF was higher and vWF-CP activity was lower in type Ⅳ than those in types of Ⅱ and Ⅲ in group LN received renal biopsy.The vWF-CP activity in the patients with membrabous nephropathy（MN）was significantly lower than that in the other pathological types of MCD,MsPGN and IgAGN（P0.05）.vWF was decreased and vWF-CP activity in the cases with SLEDAI less than 9 points increased significantly after complex therapy for 8 weeks（P0.05）.Conclusion The levels of plasma vWF and vWF-CP activity are associated with different pathological types and severeness of the CKD.

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 

分 类 号：R692[医药卫生—泌尿科学]