Detection And Clinical Significance Of White Blood Cell AnnexinⅡ And Plasma T-PA In Patients With Primary Nephrotic Syndrome

Objective:Compare the levels of white blood cell Annexin II and plasma t-PA in patients with primary nephrotic syndrome and in normal control group, to explore the significance of Annexin II and t-PA in patients with primary nephrotic syndrome.Methods:From March 2009 to September 2009, 44 cases of patients with primary nephrotic syndrome who were hospitalized in the First Affiliated Hospital of Suzhou University were enrolled in this study. 32cases were performed renal biopsy and divided groups according to different pathology types:13 patients with membranous nephropathy and 19 with other types. 2 patients with membranous nephropathy stage I,10 patients with stage II and 1 patients with stage III.Among other pathology types,14 patients with mesenterium productive nephritis,5 patients with minimal change nephritis.20 cases of healthy controls were also enrolled. White blood cell Annexin II were numerated by flow cytometry; plasma t-PA were measured by the enzyme-linked immunosorbent assay(ELISA); Hemagglutination and D-dimer were detected routine.And the clinical and laboratory data of the patients were collected.Results:1. the levels of white blood cell Annexin II in patients with primary nephrotic syndrome were significantly lower than that of in controls(P<0.01),the levels of plasma t-PA were significantly higher than that of in controls(P<0.01). 2. the levels of white blood cell Annexin II in PNS patients among different pathology type groups: The levels of Annexin II in membranous nephropathy group were lower than that of in other pathology type group(P<0.05). There were lower tendency of Annexin II levels in membranous nephropathy stage II than membranous nephropathy stage I and III. Compared with patients with membranous nephropathy,mesenterium productive nephritis and minimal change nephritis. The levels of Annexin II in membranous nephropathy showed statistic differences with mesenterium productive nephritis(P<0.05), There were lower tendency of Annexin II levels in membranous nephropathy than minimal change nephritis. The levels of plasma t-PA:there were no significant differences between membranous nephropathy group and other pathology type group(P<0.05).3. the levels of plasma fibrinogen (FIB) and D-dimer(D-Di)in patients with primary nephrotic syndrome were significantly higher than that of in control(sP<0.05, P<0.01), the levels of plasma antithrombase(AT-III)were lower than that of in controls(P<0.05).4. There was no correlation between the levels of white blood cell Annexin II and plasma t-PA in patients with primary nephrotic syndrome (r=-0.61,P<0.05).5. As for the levels of white blood cell Annexin II in PNS patients, a negative correlation was found with plasma D-dimer(r=-0.464,P<0.01), a positive correlation was found with albumin(ALB) (r=0.324,P<0.05); the levels of plasma t-PA had a negative correlation with ALB (r=-0.343,P<0.05)and positive correlations with TC(r=0.369,P<0.05), TG(r=0.332,P<0.05),LDL(r=0.031,P<0.05).Conclusion:1. The levels of white blood cell Annexin II in patients with primary nephrotic syndrome were significantly lower than that of in controls, a negative correlation was found with plasma D-dimer and a positive correlation was found with albumin.The results suggest that Annexin II may play a role in the pathogenesis of hypercoagulabale state in PNS,. The levels of Annexin II to lower may be a new mechanism of thrombokinesis in patients with NS. The levels of Annexin II may be a new marker with NS in hypercoagulable state. 2. The levels of white blood cell Annexin II in patients with membranous nephropathy decreased most obviously,may be one of new mechanisms to explain why thrombokinesis easy to be found in membranous nephropathy.3. The levels of plasma t-PA in patients with primary nephrotic syndrome were significantly higher than that of in controls,there was no correlation with the levels of white blood cell Annexin II.