紫癜性肾炎患者血清金属蛋白酶组织抑制物―1水平变化与临床意义.docVIP

紫癜性肾炎患者血清金属蛋白酶组织抑制物―1水平变化与临床意义 　　【摘要】 目的：观察不同分期过敏性紫癜性肾炎（Henoch-Schonlein purpura nephritis，HSPN）患者和健康人血清中金属蛋白酶组织抑制物-1（tissue inhibitors of metalloproteinase-1，TIMP-1）水平的变化，初步探讨TIMP-1在HSPN不同阶段中的作用及其与肾损害程度的关系，通过相关药物阻断TIMP-1的表达或抑制其活性，可能为预防、治疗肾脏纤维化提供一个新方法，以期达到理想治疗效果。方法：将过敏性紫癜性肾炎患者42例（试验组）按病理类型分组，并设立健康对照组。抽取两组的外周静脉血5 mL，分离血清，应用ELISA双抗体夹心法分别对其进行检测，观察各组TIMP-1水平的表达情况。结果：试验组Ⅱ～Ⅵ级组血清中TIMP-1水平较健康对照组显著增高（P0.05）。结论：通过检测TIMP-1水平，再结合其他化验指标和临床表现，有助于对该疾病的治疗效果或者预后给予判断，对减少肾功能衰竭发生率具有指导意义。 　　【关键词】 过敏性紫癜性肾炎； 金属蛋白酶组织抑制物-1； ELISA双抗体夹心法； 肾损害 　　【Abstract】 Objective： To study the changes of serum tissue inhibitors of metalloproteinase-1（TIMP-1） in different stages of patients with Henoch-Schonlein purpura nephritis （HSPN），to discuss the role of TIMP - 1 in HSPN and its relationship with renal damage. By blocking the expression of TIMP - 1 or inhibit its activity， to provide a new method for the treatment of renal fibrosis. Method： 42 patients with HSPN （experimental group） were divided into six groups according to the pathological types， and normal control group was set up. 5 mL peripheral vein blood from all of the research object were extracted and separated its serum. Double antibody sandwich ELISA method was used to detect the expression of IMP-1 in each group. Result： The levels of serum TIMP-1 in II ?C VI grade HSPN were significantly higher than those in the normal control group （P0.05）. Conclusion： By detecting TIMP - 1 level， in combination with other test indicators and clinical symptoms， can help the treatment of the disease or to judge prognosis， it has the instruction significance to reduce the incidence of renal failure. 　　【Key words】 Henoch-Schonlein purpura nephritis； Tissue inhibitor of metalloproteinase -1； Double antibody sandwich ELISA method； Renal damage 　　过敏性紫癜性肾炎（Henoch-Schonlein purpura nephritis，HSPN）是继发于过敏性紫癜的肾脏损害，是造成儿童慢性肾损害的常见原因之一。病理改变以全身性小血管损害及肾小球系膜病变为主，国际儿科肾脏病学会（ISKDC）推荐的诊断标准因更适用于临床而被广泛应用，临床常见急进性肾炎及肾病综合症，以血尿、蛋白尿为主要表现，可伴高血压和肾衰竭。目前国内外临床深入研究紫癜性肾炎的发病机理，预防慢性肾功能衰竭