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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 investigate the effect and mechanism of defibrase on plasma plasminogen activator inhibitor 1 (PAI-1) expression in patients with primary nephritic syndrome. Methods Seventy-eight patients with primary nephrotic syndrome admitted to our hospital from September 2012 to April 2013 were randomly divided into defibrase group and non-defibrase group, while non-defibrase group was given conventional drug treatment. Fibrinolytic group in the non-defibrase group based on the drug treatment, plus defibrase treatment. The plasma PAI-1 levels were measured by enzyme-linked immunosorbent assay (ELISA) before and 3 days, 14 days and 33 days after treatment. The levels of serum hs-PCR, Cholesterol (Tch), triglyceride (TG), fibrinogen (Fg), 24-hour urinary protein and homocysteine (Hcy) levels were measured and their correlations with PAI-1 levels were analyzed. Results (1) The levels of PAI-1 in defibrase group after 3 days, 14 days and 33 days after treatment were lower than those in non-defibrase group before and after treatment (P <0.01); ( 2) There was a positive correlation between PAI-1 expression and 24-hour urinary protein and Hcy levels (all P <0.05). Conclusion Defibrase can effectively control the expression of PAI-1 in the plasma of patients with nephrotic syndrome and delay the development of the nephrotic syndrome.