狼疮性肾炎热瘀证与肾脏病理及局部凝血纤溶的相关性分析

Correlation between Heat-blood Stasis Syndrome and Renal Pathological Changes,Local Coagulation and Fibrinolysis in Lupus Nephritis Patients

目的研究狼疮性肾炎热瘀证与肾脏病理及局部凝血纤溶的相关因素。方法采用电镜及免疫组化方法对30例狼疮性肾炎热瘀证与30例狼疮性肾炎非热瘀证肾脏病理分型、肾组织活动指数(AI)及慢性化指数(CI)、肾组织纤维蛋白原相关抗原(FRA)、组织型纤溶酶原激活物(tPA)和1型纤溶酶原激活物抑制物(PAI-1)进行对比分析。结果狼疮性肾炎热瘀证与肾脏病理分型无相关性;热瘀证组肾脏病理的AI显著高于非热瘀证组(P<0.01);热瘀证组肾组织FRA沉积程度明显强于非热瘀证组(P<0.05);热瘀证组tPA、PAI-1阳性强度平均积分显著高于非热瘀证组(P<0.05)。结论狼疮性肾炎热瘀证与肾脏病理活动及肾脏局部高凝和纤溶低下有一定相关性。

Objective To observe the relevant factor of heat-blood stasis syndrome with renal pathological changes and local coagu- lation and fibrinolysis in patients with lupus nephritis （LN）. Methods Thirty LN patients with heat-blood stasis syndrome and 30 LN patients without heat-blood stasis syndrome were observed with electron microscope and immunohistochemical method for the analysis on renal pathological classification, renal activity index （AI）, chronic index （CI）, renal tissue fibrinogen-related antigen （FRA）, tissue plasminogen activator （tPA）, and plasminogen activator inhibitor-1 （PAI-1） for comparison. Results There was no correlation between heat-blood stasis syndrome and renal pathological changes; renal AI of heat-blood stasis syndrome group was significantly higher than that of non-heat-blood stasis syndrome group （P（0.01）3 the FRA deposition of heat-blood stasis syndrome group was significantly stronger than that of non-heat-blood stasis syndrome group （P^0.05）; the average scores of positive intensity of tPA and PAI-1 of heat-blood stasis syndrome group were significantly higher than those of non-heat-blood stasis syndrome group （P〈0.05）. Conclusion The heat-blood stasis syndrome in LN patients correlates with the acitity of renal pathological changes, high local coagulation and low fibrinolysis.