Farid Farida Ahmed, Mohammed Ahmed Abdullah, Afifi Hanaa Mohammed, Beltagi Rania Saleh
Department of Paediatrics Ain Shams University, Cairo, Egypt.
SAJCH. 2011 Dec;5(4):107-111.
Tissue factor pathway inhibitor is an endogenous protease inhibitor that regulates the initiation of the extrinsic coagulation pathway by producing factor Xa-mediated feedback inhibition of the tissue factor/factor VIIa (TF/VIIA) catalytic complex. OBJECTIVES: To evaluate plasma TFPI levels in paediatric patients with nephrotic syndrome and its correlation with disease activity. SUBJECTS AND METHODS: Fifteen nephrotic patients in relapse (proteinuria>40mg/m2/hour, hypoalbuminemia, and edema) before initiating steroid therapy (Group I), and another15 nephrotic patients in remission after withdrawal of steroid therapy (Group II) were compared to 15 age- and sex-matched healthy children (Group III). Besides clinical evaluation and routine laboratory investigations of nephrotic syndrome, tissue factor pathway inhibitor levels in plasma were measured by ELISA. RESULTS: Plasma TFPI level was higher in nephrotic patients during relapse (Group I) and during remission (Group II) [102.53±14.23 and 82.93±3.83ng/ml respectively] compared to that in the control group (62.40 ± 7.53 ng/ml) (p< 0.0001). In children with nephrotic syndrome Plasma TFPI level was higher during relapse (Group I) compared to that in remission (Group II) (p< 0.0001). There was a negative correlation between plasma TFPI level and total protein and serum albumin, and there was a positive correlation between plasma TFPI level and urine protein /creatinine ratio with a statistically significant difference (p< 0.05). CONCLUSION: Nephrotic syndrome was associated with increased level of plasma tissue factor pathway inhibitor in comparison to control group and the increase was more apparent in patients with active disease.
组织因子途径抑制物是一种内源性蛋白酶抑制剂，通过产生因子Xa介导的对组织因子/因子VIIa（TF/VIIa）催化复合物的反馈抑制来调节外源性凝血途径的启动。目的：评估肾病综合征患儿的血浆TFPI水平及其与疾病活动度的相关性。对象与方法：将15例复发期肾病患者（蛋白尿>40mg/m²/小时、低白蛋白血症和水肿）在开始使用类固醇治疗前（I组），以及另外15例在停用类固醇治疗后缓解期的肾病患者（II组）与15例年龄和性别匹配的健康儿童（III组）进行比较。除了对肾病综合征进行临床评估和常规实验室检查外，采用酶联免疫吸附测定法测定血浆组织因子途径抑制物水平。结果：与对照组（62.40±7.53ng/ml）相比，复发期（I组）和缓解期（II组）肾病患者的血浆TFPI水平更高[分别为102.53±14.23和82.93±3.83ng/ml]（p<0.0001）。肾病综合征患儿复发期（I组）的血浆TFPI水平高于缓解期（II组）（p<0.0001）。血浆TFPI水平与总蛋白和血清白蛋白呈负相关，与尿蛋白/肌酐比值呈正相关，差异有统计学意义（p<0.05）。结论：与对照组相比，肾病综合征患者血浆组织因子途径抑制物水平升高，且在疾病活动期患者中升高更为明显。
