| Objective Detect soluble endothelial cell plasma protein C receptor (sEPCR), P-selectelement, fibrinolytic enzyme inhibition the activation thing (PAI-1), TGF-β1level byELISA method in90cases of chronic kidney disease patients and analysis the correlationbetween the clinical data, such as blood pressure,24h urine protein, creatinine level ect.To analyzes on the significance of sEPCR in chronic kidney disease, and preliminarydiscussion the relationships between sEPCR and platelet activation, fibrinolytic anomaliesand renal fibrosis.Methods From February2011to December2011,90cases of patients with chronickidney disease (male/female:52/38)who were hospitalized in the First Affiliated Hospitalof Soochow University were enrolled in this study(Definition and phases were based on K／DOQI chronic kidney disease clinical practice guidelines,2005),20cases of healthycontrols (male/female:12/8)were also enrolled. Circulating sEPCR,P selectins,PAI-1and TGF-β1were measured by the enzyme linked immunosorbem assay；The bloodpressure,height and weight of all subjects were measured also．The abbreviated MDRDequation to calculate GFR.eGFR=175*[Scr(mg*dl-1)]-1.234*[Year]-0.179*[Female*0.79][(ml*min-1*1.73m2)]Fasting venous blood samples were extracted to detect hemoglobin,serum creatinine,blood cholesterol,blood glucose；Urinary protein was detected by radioimmunoassay．Results1, Plasma sEPCR level in CKD group was significantly higher than the control group(P <0.05). CKD1-2stages were no significantly different (P>0.05), sEPCR levelin CKD3-5increased significantly compared to control group (P <0.05); sEPCRlevel in CKD5period was higher than CKD1-4period (P <0.01). Chronic nephritisgroup, the high blood pressure group of kidney disease, lupus nephritis group, diabetic nephropathy group sEPCR level were higher than health control group (P<0.05), sEPCR levels in diabetic nephropathy group and lupus nephritis group,were significantly higher than high blood pressure kidney disease and chronicnephritis group (P <0.05).2, P selectins level in CKD1and CKD2do not exist differences in plasma. While Pselectins level in CKD3-5is obvious higher than normal control(P<0.05).Whentake any two stages of CKD into comparisonCKD5stage have obvious difference with CKD1to CKD4seperately (P <0.05). Pselectins level in all CKD stages was higher than that of control group health (P <0.05).diabetic nephropathy group,lupus nephritis group,chronic nephritis groupincreased significantly than hypertension kidney disease group (P <0.05).3, PAI-1level in CKD group was significantly higher than the control group (P <0.05). CKD1-2stages were no significantly different (P>0.05), PAI-1level inCKD3-5increased significantly compared to control group (P <0.05);PAI-1inCKD5period was higher than CKD1-4period (P <0.01). PAI-1level in DN andLN groups was higher than chronic nephritis group and hypertensive nephropathygroup (P <0.05).4, TGF-β1levels are obviously different with the control group (P <0.05)。We did notfound obvious statistic difference about TGF-β1levels among CKD cause groups.CKD5stage have obvious difference with CKD1to CKD4seperately (P <0.05).5, Correlation analysis: sEPCR level and P selectins,PAI-1, TGF-β1levels werepositively correlated (r=0.35, P <0.01; r=0.24, P <0.05; r=0.31; P <0.01). Thelevel of plasma sEPCR positively correlated with systolic blood pressure (r=0.48,P <0.01), diastolic pressure is positively related (r=0.235, P <0.05); sEPCR levelwas positively associated with creatinine (r=0.42, P <0.05).And24hours urinaryprotein quantitative, hemoglobin, blood cholesterol did not related significantly. Conclusion1, The plasma sEPCR,P selectins, PAI-1in patients with CKD show a significantlyhigher level than control group, which suggesting CKD patients have endothelial cellinjury,platelet activation,fibrinolytic abnormal pathophysiological state.2, sEPCR,P selectins,PAI-1,TGF-β1have positive relationship.In patients withchronic kidney disease (CKD), the endothelial cell injury, platelet activation,fibrinolytic abnormalities work together to renal fibrosis progress. |
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