降纤酶对肾病综合征患者血浆PAI-1的影响及作用机制研究

Research on the Effect and Mechanism of Defibrase on Plasma PAI-1 in Patients with Nephrotic Syndrome

目的探讨降纤酶治疗对原发性肾病综合征患者血浆中纤溶酶原激活物抑制剂1(PAI-1)表达水平的影响及其作用机制。方法选取2012年9月—2013年4月我院收治的68例原发性肾病综合征患者,随机分为降纤酶组和非降纤酶组,非降纤酶组给予常规药物治疗,降纤酶组在非降纤酶组药物治疗的基础上,加用降纤酶治疗。采用酶联免疫吸附(ELISA)法于治疗前与治疗后3天、14天和33天检测两组患者血浆内的PAI-1表达水平,测定血清超敏C反应蛋白(hs-PCR)、总胆固醇(Tch)、甘油三酯(TG)、纤维蛋白原(Fg)、24小时尿蛋白定量和同型半胱氨酸(Hcy)水平,并分析其与PAI-1水平的相关性。结果 (1)降纤酶组患者治疗后3天、14天和33天的PAI-1水平均低于治疗前和同期非降纤酶组,差异均有统计学意义(P<0.01);(2)PAI-1表达水平与24小时尿蛋白定量、Hcy水平呈正相关,差异均有统计学意义(P<0.05)。结论降纤酶能够有效地控制肾病综合征患者血浆中PAI-1表达,延缓原发性肾病综合征病情的发展。

OBJECTIVE To explore the effect and mechanism of plasminogen activator inhibitor-1 （PAI-1） level in plasma in patients suffered from primary nephritic syndrome after treatment with defibrase. METHODS 68 patients with primary nephrotic syndrome were selected from September 2012 to April 2013 in our hospitol. These patients was randomly devided into defibrase group and group. The nondefibrase group received conventional medicine therapy, while the defibrase group were treated with defibrase based on the nondefibrase group. Enzyme-linked immunosorbent assay （ELISA） was wsed to detect the changes of PAI-1 levels in plasma of each group before and the 3rd dayscnd 14th days and 33rd days after treatment. Detected the contents of hypersensitivity C-protein （hs-PCR） , total cholesterol （Tch）, triglyceride （TG）, fibfinogen （Fg）, 24-hour urinary protein and homocysteine （Hcy）, and then anal- ysed their correlations with PAI-1. RESULTS （1）The levels at the 3rd, 14th and 33rd day in the defihrase group were all lower than before treatment and the nondefibrase group at the corresponding periods. The differences were all statistically significant （P〈0.01）; （2） PAI-1 level was positively correlated with 24-h urinary protein and Hcy（P〈0.05）. CONCLUSIONS Defibrase could effectively control the expression of PAI-1 in plasma of patients suffered from primary nephrotic syndrome and delay the progression of the dis-