肾病综合征患者血浆脂蛋白(a)水平与纤溶活性变化的研究

Relationship between plasma level of lipoprotein(a) and fibrinolytic activity in patients with nephritic syndrome

目的研究肾病综合征(NS)患者血浆脂蛋白(a)[Lp(a)]水平与血中纤溶活性的关系。方法用透射比浊法测定56例NS患者的Lp(a)浓度;用发色底物显色法测定组织型纤溶酶原激活剂(tPA)及其抑制物(PAI)活性。取48例同期的健康体检者作为对照。结果NS患者组PAI活性及血浆Lp(a)水平显著高于对照组,差异有统计学意义(t分别=2.13、2.44,P均<0.05);其tPA活性显著低于对照组,差异有统计学意义(t=3.05,P<0.05)。NS患者的Lp(a)浓度与PAI活性及BUN、Scr水平显著正相关(r分别=0.69、0.65、0.59,P均<0.05),与tPA活性显著负相关(r=-0.50,P<0.05)。结论血浆Lp(a)浓度升高与纤溶活性低下有关,可能是NS并发心脑血管疾病的独立危险因素,临床要对其进行监测。

Objective To study the relationship between plasma level of lipoprotein （a） [Lp（a）] and fibrinolytic activity in patients with nephritic syndrome （NS）. Methods The plasma level of Lp（a） were measured by enzymelinked immunosorbent assay （ELISA） in 56 patients with NS. Plasma activity of tissue type plasminogen activator （tPA） and plasminogen activator inhibitor （PAI） were determined by spectrophotometry. 48 healthy subjects were taken as control group. Results Plasma level of Lp（a） and PAI activity in NS group were significantly higher than that of control group （t=2.13, 2.44,P〈0.05）. The activity of tPA in NS group was significantly lower than control group（t=- 3.05, P〈0.05）. Plasma level of Lp（a） in NS group was positively correlated with PAI activity, plasma level of BUN and Cr （r=0.69,0.65,0.59,P〈0.05）, while negatively correlated with tPA activity （r=-0.50,P〈0.05）. Conclusions High plasma level of Lp （a） was related with the low fibrinolytic activity. It was a independent risk factor of cardiovascular complication and should be monitored in clinical practice.