Shibata T, Sumie A, Ishii T, Tomo T, Magari Y, Sato J, Yasumori R, Nasu M
Second Department of Internal Medicine, Oita Medical University, Japan.
Nihon Jinzo Gakkai Shi. 1993 Jun;35(6):687-94.
In order to clarify the abnormalities of intra-glomerular coagulation and fibrinolysis in patients with various renal diseases, urinary fibrin/fibrinogen degradation products (FDP) have been examined by several methods. We established a highly sensitive new method of enzyme-linked immunosorbent assay for urinary FDP. The results were as follow: 1) The mean +/- SD of urinary FDP in normal subjects was 10.30 +/- 9.08ng/ml. 2) The urinary FDP levels in chronic glomerulonephritis, nephrotic syndrome and chronic renal failure patients were significantly higher than normal subjects, and the levels in SLE, Alport's syndrome patients were higher than normal subjects. 3) The urinary FDP levels were a little bit higher in the patients with proliferative glomerulonephritis than in chronic glomerulonephritis patients with minor lesion or membranous nephropathy. 4) There was significant correlation between urinary FDP and urinary protein in chronic glomerulonephritis, while there was no correlation in nephrotic syndrome. 5) There was no correlation between urinary FDP and intra-glomerular fibrin deposits examined by immunofluorescent study in chronic glomerulonephritis, while in nephrotic syndrome, there were high levels of urinary FDP in the positive fibrin deposits cases. These results suggested that the most of the part of excretion of the urinary FDP in chronic glomerulonephritis is associated with the filtration of blood FDP to urine through the glomerular basement membrane, while in the nephrotic syndrome cases the origin of urinary FDP is related to the filtration and/or the intra-glomerular coagulation abnormalities.
为了阐明各种肾脏疾病患者肾小球内凝血和纤维蛋白溶解的异常情况,已采用多种方法检测尿纤维蛋白/纤维蛋白原降解产物(FDP)。我们建立了一种高度灵敏的酶联免疫吸附测定尿FDP的新方法。结果如下:1)正常受试者尿FDP的均值±标准差为10.30±9.08ng/ml。2)慢性肾小球肾炎、肾病综合征和慢性肾衰竭患者的尿FDP水平显著高于正常受试者,系统性红斑狼疮、阿尔波特综合征患者的尿FDP水平高于正常受试者。3)增殖性肾小球肾炎患者的尿FDP水平略高于轻度病变或膜性肾病的慢性肾小球肾炎患者。4)慢性肾小球肾炎患者尿FDP与尿蛋白之间存在显著相关性,而肾病综合征患者则无相关性。5)慢性肾小球肾炎患者尿FDP与免疫荧光研究检测的肾小球内纤维蛋白沉积之间无相关性,而在肾病综合征中,纤维蛋白沉积阳性病例的尿FDP水平较高。这些结果表明,慢性肾小球肾炎患者尿FDP排泄的大部分与血FDP通过肾小球基底膜滤入尿液有关,而在肾病综合征病例中,尿FDP的来源与滤过和/或肾小球内凝血异常有关。