血栓调节蛋白在系膜增生性肾小球肾炎中的相关探讨

The correlution of TM in the pathology of mesangial proliferative glomerulonephritis

目的:探讨系膜增生性肾小球肾炎(MsPGN)患者血浆中血栓调节蛋白(PTM)的水平与肾功能、蛋白尿、凝血功能、血脂之间的关系。方法:54例经肾穿刺活检明确诊断的MsPGN患者,采用酶联免疫吸附法(ELISA)检测血浆PTM水平。依照蛋白尿的程度将病人分为两组:(1)大量蛋白尿组,24h尿蛋白定量大于3.5 g。(2)少量蛋白尿组,24 h尿蛋白定量小于3.5 g。结果:大量蛋白尿组的PTM浓度、纤维蛋白原(Feb)、甘油三酯和总胆固醇均比少量蛋白尿组高,两组之间有统计学差异(P<0.05)。而少量蛋白尿组的白蛋白比大量蛋白尿组高(P<0.05),两组CCr相比没有显著性差异。所有病人的PTM与其他指标的相关性分析显示PTM与Feb和蛋白尿呈正相关(r=0.371r、=0.505,P均<0.05),PTM随着Feb和蛋白尿的增加而增高。PTM与白蛋白呈负相关(r=-0.491,P<0.05),PTM随着白蛋白降低而增高。PTM与CCr、甘油三酯和总胆固醇无相关性(P>均0.05)。结论:血浆PTM水平与蛋白尿的程度相关。血浆PTM与蛋白尿的水平不仅是(MsPGN)病变程度的指标,并且可为指导治疗和判断预后提供依据。

Objective- Research the relationship between the level of plasmathrombomodulin（PTM）, and renal function, coagulation,serum cholesterol and triglyceride. Methods： Fifty-four patients which diagnosed as mesangial proliferative glomerulonephritis（MsPGN） by renal biopsy. Enzyme-linked immunosorbent assay （ELISA） was used to detect the level of PTM. patients were divided into two groups according to pro- teinuria：the large proteinuria group with proteinuria more than 3.5 g/24 h, the small proteinuria group with proteinuria less than 3.5 g/24 h. Results： The density of PTM, Feb, serum cholesterol and triglyceride in large proteinuria group were higher statistically significant difference between the two groups （P〈0.05）. However the albumin was higher in small proteinuria group （P 〈0.05）. Ccr in two groups had no significant difference. All patients with other indicators of the PTM correlation analysis showed that PTM and fibrinogen （Feb） and proteinuria were positively correlated （r=0. 371, r = 0. 505, P 〈0. 005）. With the increasing of Feb and proteinuria, PTM increased. PTM and albumin were negatively correlated （r =- 0. 491, P 〈0.05）. With the increasing of albumin, PTM decreased. There was no correlation between PTM and Ccr, serum cholesterol, triglyceride. Conclusion： The level of PTM have correlation with proteinuria. The level of PTM and proteinuria is not only the mark of lesion in MsPGN, but also guide to treatment and proof of predicting prognosis.