The Expression And Significance Of T-PA And PAI-1 On Hepatitis B Virus Associated Glomerulonephritis

【Objective】1. To summarize the clinical pathology features of Hepatitis B virus associated glomerulonephritis.2. To study the significance and expression of t-PA and PAI-1 on Hepatitis B virus associated glomerulonephritis.3. To learn the relations between fibrinolytic system represented by t-PA/PAI-1 and Clinical prognosis.【Methods】1. Totally 100 kidney biopsy samples from the department of nephrology and the department of pathology were chosen to be the research target, which must be diagnosed as HBV-GN and had complete clinical and pathological data. We summarized the clinical features of HBV-GN by sorting out all the clinical data, and explored the light microscopy, immunohistochemical and ultrastructural characteristics of HBV-GN in accordance with the grouped pathological types of HBV-GN at the same time.2. We studied the significance of t-PA and PAI-1 expression on HBV-GN between the control group and experimental group, and analyzed the relations between t-PA/PAI-1 and clinical prognosis. 【Results】1. From a total 100 patients, among which male were severely predominant (M:F = 2.57:1). The clinical presentation of HBV-GN varied from nephrotic syndrome(53.0%), proteinuria+ hematuria(30.0%), massive proteinuria(12.0%) to simple hematuria(5.0%).2. The most frequent pathologic finding of HBV-GN was MN (35.0%), followed by MsPGN(25.0%), MPGN(15.0%) and IgAN(12.0%) ,the other types such as MCG(8.0%)and SGN(5.0%) are not common.3. T-PA/PAI-1 were nearly negative in the control group, while positive in the experimental group.4. In the pathological types of HBV-GN, the average scores of t-PA in SGN were the lowest, while the PAI-1 scores were the highest. However, there were no significant differences among other pathologic types.5. Among the different grades of the glomerular lesions, the positive t-PA scores of gradeⅡand gradeⅢbegan to increase, while declined in gradeⅣ. GradeⅢof t-PA scores were significantly higher than another grades(P<0.05). The PAI-1 scores increased with degrees of glomerular lesions, there were significant difference among them (P<0.05, P<0.01). Besides, of the same grade, PAI-1 scores were significantly more than t-PA scores (P<0.05). The difference of them is helpful in statistics.6. PAI-1 scores increased with renal function declining (P<0.05, P<0.001). The difference is beneficial to statistic study.【Conclusion】1. There were different clinical presentations in HBV-GN. Nephrotic syndrome and proteinuria+ hematuria were common. The most common pathologic finding of HBV-GN was MN, followed byMsPGN, MPGN, IgAN, MCG and SGN.2. T-PA/PAI-1 didn't express on Normal renal tissue, while expressed obviously on the HBV-GN. 3. The positive deposition of T-PA/PAI-1 had no association with different types of HBV-GN, it was only related with the degree of glomerular lesions.4. The disorder of fibrinolytic system represented by t-PA/PAI-1 reduced ECM degradation, and speeded the sclerosis of glomerulosclerosis.5. PAI-1 scores increased while renal function declining, which can be one signal of the poor prognosis in HBV-GN.