Suzuki S, Takahashi H, Sato H, Takashima N, Arakawa M, Gejyo F
Department of Clinical and Laboratory Science, Fukui Medical School, Japan.
Am J Nephrol. 1997;17(6):499-504. doi: 10.1159/000169177.
Apolipoprotein (a) [apo(a)] may interfere with the fibrinolytic system because of its structural similarity to plasminogen. In the present study, we evaluated the effect of glomerular deposition of apo(a) on coagulation and fibrinolysis in patients with glomerular diseases. Twenty-four patients (13 males and 11 females) with various glomerulopathies were studied. We examined renal biopsy specimens for the presence of apo(a), and investigated the relationship between the glomerular deposition of apo(a) and coagulation and fibrinolysis within the glomeruli. The patients who exhibited the deposition of apo(a) (group A) had a significantly higher incidence of deposition of apo B-100 and low-density lipoprotein (LDL) receptor, and a significantly lower incidence of deposition of plasmin-alpha 2-plasmin inhibitor complexes (PIC) and tissue-type plasminogen activator than did patients without apo(a) deposition (group B). Patients in group A had a significantly higher level of serum total cholesterol and lipoprotein (a) than did patients in group B. Plasma levels of PIC and D-dimer in group A were significantly lower than those in group B. The plasma level of thrombin-antithrombin III complexes in group A was significantly higher than that in group B. These findings suggest that glomerular apo(a) deposition plays a part in coagulation and fibrinolysis within the glomeruli in patients with glomerular diseases.
载脂蛋白(a)[apo(a)]因其与纤溶酶原的结构相似性，可能会干扰纤维蛋白溶解系统。在本研究中，我们评估了apo(a)在肾小球疾病患者肾小球中的沉积对凝血和纤维蛋白溶解的影响。研究了24例患有各种肾小球病的患者（13例男性和11例女性）。我们检查肾活检标本中apo(a)的存在情况，并研究了apo(a)在肾小球中的沉积与肾小球内凝血和纤维蛋白溶解之间的关系。表现出apo(a)沉积的患者（A组）中，载脂蛋白B-100和低密度脂蛋白（LDL）受体沉积的发生率显著更高，而纤溶酶-α2-纤溶酶抑制剂复合物（PIC）和组织型纤溶酶原激活物沉积的发生率显著低于没有apo(a)沉积的患者（B组）。A组患者的血清总胆固醇和脂蛋白(a)水平显著高于B组患者。A组的PIC和D-二聚体血浆水平显著低于B组。A组的凝血酶-抗凝血酶III复合物血浆水平显著高于B组。这些发现表明，肾小球apo(a)沉积在肾小球疾病患者的肾小球内凝血和纤维蛋白溶解中起作用。
