Małyszko J, Małyszko J S, Pawlak D, Pawlak K, Rydzewski A, Myśliwiec M, Buczko W
Nephrology Department, Bia-ystok Medical School, Poland.
Pol J Pharmacol. 1996 Mar-Apr;48(2):191-5.
A comprehensive study on platelet aggregation, hemostasis, fibrinolysis and serum lipids in relation to peripheral serotonergic system has been performed on 41 nephrotic patients. Enhanced platelet aggregatory responses in both whole blood and in platelet rich plasma (PRP) were found upon stimulation with different agonists when compared to healthy volunteers. Increased levels of fibrinogen, fibrin monomers, and protein C activity were observed in nephrotic patients. Euglobulin clot lysis time was significantly prolonged in nephrotic patients. Activity of tissue plasminogen activator (tPA) inhibitor was higher in nephrotic syndrome, whereas tPA activity was significantly lower in these patients when compared to controls. Urokinase concentration, lipoprotein (a), cholesterol, LDL and VLDL levels were significantly higher in nephrotic patients over controls. Whole blood serotonin was significantly lower, whereas plasma serotonin was significantly higher in nephrotic patients relative to controls. Serotonin uptake and its release from platelets were markedly diminished in patients with nephrotic syndrome. Disequilibrium in the coagulolytic system, platelet hyperactivity, hyperfibrinogenemia, disturbances in peripheral serotonergic system together with lipid abnormalities may contribute to the progression and development of atherosclerosis and an enhanced risk of thromboembolic complications in nephrotic syndrome.
对41例肾病患者进行了一项关于血小板聚集、止血、纤维蛋白溶解和血脂与外周血清素能系统关系的综合研究。与健康志愿者相比，在不同激动剂刺激下，全血和富血小板血浆（PRP）中的血小板聚集反应均增强。肾病患者的纤维蛋白原、纤维蛋白单体和蛋白C活性水平升高。肾病患者的优球蛋白凝块溶解时间显著延长。肾病综合征中组织纤溶酶原激活物（tPA）抑制剂的活性较高，而与对照组相比，这些患者的tPA活性显著较低。肾病患者的尿激酶浓度、脂蛋白（a）、胆固醇、低密度脂蛋白和极低密度脂蛋白水平显著高于对照组。与对照组相比，肾病患者的全血血清素显著降低，而血浆血清素显著升高。肾病综合征患者血小板对血清素的摄取及其释放明显减少。凝血溶解系统失衡、血小板活性过高、纤维蛋白原血症、外周血清素能系统紊乱以及脂质异常可能导致动脉粥样硬化的进展和发展，并增加肾病综合征患者血栓栓塞并发症的风险。
