慢性肾功能衰竭患者血浆脂蛋白(a)与纤溶活性的相关性_医学论文.docVIP

慢性肾功能衰竭患者血浆脂蛋白(a)与纤溶活性的相关性_医学论文 慢性肾功能衰竭患者血浆脂蛋白(a)与纤溶活性的相关性_医学论文 作者：闫智宏 朱晓波 梁庆智 【摘要】 目的：研究慢性肾功能衰竭患者血浆脂蛋白（a）与纤溶活性的关系。方法：应用酶联免疫吸附法分别测定58例慢性肾功能衰竭患者及51名健康对照者的血浆脂蛋白（a）浓度，并以底物显色法测定其组织型纤溶酶原激活剂（tPA）及其抑制物（PAI）活性。结果：慢性肾功能衰竭患者血浆脂蛋白（a）浓度和PAI活性明显升高，tPA活性明显降低；脂蛋白（a）浓度与血浆尿素氮水平、PAI活性均呈正相关；脂蛋白（a）浓度与tPA活性呈负相关。结论：肾功能对血浆脂蛋白（a）浓度起一定的调节作用，脂蛋白（a）水平的升高与纤溶活性低下有关。 【关键词】 脂蛋白(a)；慢性肾功能衰竭；纤溶酶原激活剂；纤溶酶原激活剂抑制物 【ABSTRACT】 Objective:To investigate the correlation between plasma lipoprotein(a) levels and fibrinolytic activation in patients with chronic renal failure. Methods:The plasma lipoprotein(a) concentrations were measured by enzyme linked immunosorbent assay in 58 patients with chronic renal failure and 51 healthy objects. Plasma activity levels of tissue type plasminogen activator (tPA) and plasminogen activator inhibitor (PAI) were determined by spectrophotometric assay respectively. Results:The plasma lipoprotein (a) concentrations and activity of PAI in chronic renal failure patients were significantly higher than those control group,however plasma activity of tPA in chronic renal failure patients was significantly lower than that of control group. The plasma lipoprotein(a) concentration was significantly positive correlated with plasma BUN concentration and activity of PAI,but it was significantly negative correlated with activity of tPA.Conclusion:It indicates that renal function may contribute to regulating plasma lipoprotein(a) levels,elevating lipoprotein(a) concentration and lowering fibrinolytic activation. 【KEY WORDS】 Lipoprotein(a)Chronic renal failurePlasminogen ActivatorPlasminogen Activator Inhibitor 脂蛋白（a）[Lipoprotein(a)，Lp(a)]是存在于血浆中的一类正常脂蛋白，脂质成分与LDL相似，而载脂蛋白（apo）成分为apoB100和特征性的apo(a)，二者以二硫键相连。Lp(a)与心脑血管疾病的关系已得到普遍认同[1]。由于慢性肾功能衰竭（CRF）患者普遍存在脂代谢紊乱，且为心脑血管疾病高发人群[2，3]。故Lp(a)与CRF的关系日益受到人们的关注。已有研究发现CRF患者血浆中的Lp(a)水平也升高[2，3]，但CRF患者血Lp(a)升高的原因以及高Lp(a)水平是否参与肾脏病变过程鲜有报道。本文观察CRF患者血浆Lp(a)浓度与组织型纤溶酶原激活剂（tPA）及其抑制物（PAI）活性的变化，探讨其临床意义。 1 资料与方法 1.1 研究对象 经临床和病理确诊的CRF患者58例(BUN＞22mmol/L,Scr＞445μmol