肾病综合征患者血浆血小板源活化因子的变化及临床意义

Clinical Significance of Changes of Plasma Concentrations of Activators of Platalet Origin in Patients with Primary Nephrotic Syndorme (PNS)

目的 :观察原发性肾病综合征 (PNS)患者血浆中血栓素B2 (TXB2 )、血小板α -颗粒膜蛋白 (GMP -14 0 )的浓度水平 ,探讨其与肾损害程度、治疗效果及转归的关系。方法 :PNS患者 31例 ,只接受强的松和对症治疗 ,对照组 31例 ;TXB2 采用放射免疫分析 ,GMP - 14 0用双抗体夹心免疫放射分析。结果 :PNS患者血浆中TXB2 含量明显高于正常人 (P <0 0 1) ,使用糖皮质激素治疗后敏感组较治疗前显著下降并接近正常人水平 ,激素依赖、无效组治疗前后无明显变化 (P >0 0 5 ) ;PNS患者血浆中GMP - 14 0变化与TXB2 呈显著正相关 (r=0 .6 94 5 ,t=3.6 134,P <0 .0 1)。结论 :PNS患者血中TXB2 、GMP - 14 0含量显著高于正常人 ,观察激素治疗前后二者的变化 ,可作为判断PNS患者疗效和预后的重要指标之一。

Objective To study the relationship between plasma concentrations of thromboxance (TXB 2)、platalet α-granule membrane protein (GMP-140) and progression of the disease process in patients with primary nephrotic syndrome. Methods Plasma TXB 2(with RIA) and GMP-140 (with IRMA) concentrations were determined in 31 patients with PNS both before and after prednisone treatment as well as in 31 controls. Results Plasma contents of TXB 2 in patients wiht PNS were significantly higher than those in the controls (P<0.01). After prednisone therapy, those who responded well to treatment had their plasma TXB 2 concentrations dropped markedly to near normal levels. However, those who were prednisone-dependent or non-responsive had little changes in TXB 2 levels (P>0.05). Plasma GMP-140 concentrations were significantly positively correlated with plasma TXB 2 concentrations (r=0.6945,t=3.6134,P<0.01). Conclusion A fall of plasma TXB 2 and GMP-140 concentrations after prednisone therapy is an indicator of treatment success with good prognosis.