纤溶酶原激活物抑制因子1基因多态性与过敏性紫癜胃肠道出血的相关性

摘要

Objective To investigate the relationship of single nucleotide polymorphism (4G/5G) in the promoter of plasminogen activator inhibitor-1 (PAI-1) and plasma PAI-1 level with gastrointestinal bleeding in Henoch-Schönlein purpura (HSP). Methods A total of 524 children with HSP in acute phase were recruited, and divided into gastrointestinal bleeding group (bleeding group, n = 186) and non-gastrointestinal bleeding group (control group, n = 338). The genotype frequency of 4G/5G polymorphism, the plasma PAI-1 level, and other parameters related to coagulation and ifbrinolysis were measured and compared between two groups. Results The levels of platelet count (PLT), platelet distribution width (PDW), serum D dimer (DD), serum PAI-1 were signiifcantly higher in the bleeding group than those in the control group, and the levels of mean platelet volume (MPV) and plasma ifbronectin protein of ifbrinogen (FIB) were signiifcantly lower in the bleeding group than those in the control group (P < 0.05). The genotype frequency of 4G/4G was signiifcantly higher in the bleeding group than that in the control group (P = 0.044). The plasma PAI-1 level and DD level was high in 4G/4G genotype. Conclusions The gene polymorphism of PAI-1 4G/5G may affect the pathological process of gastrointestinal bleeding in HSP by inlfuencing the expression of PAI-1 and other factors related to coagulation and ifbrinolysis systems.%目的：研究纤溶酶原激活物抑制因子1（PAI-1）基因启动子区单核苷酸多态位点（4G/5G）和血浆PAI-1水平与过敏性紫癜（HSP）胃肠道出血的相关性。方法入选HSP急性期患儿524例，按是否有消化道出血分为消化道出血组（出血组，186例）和非消化道出血组（对照组，338例），比较分析两组患儿PAI-1基因型、PAI-1血清水平以及其他和凝血纤维溶解相关的指标。结果出血组患儿的血小板计数（PLT）、血小板分布宽度（PDW）、血清D-二聚体（DD）、血清PAI-1水平均高于对照组，而平均血小板体积（MPV）和血浆纤维蛋白原（FIB）水平低于对照组，差异均有统计学意义（P < 0.05）；出血组患儿的4G/4G基因型频率较对照组高，差异有统计学意义（P=0.04）。4G/4G基因型的血浆PAI-1水平、DD水平高。结论 PAI-14G/5G基因多态性可能通过影响血浆PAI-1表达水平以及凝血纤溶等因素而影响过敏性紫癜消化道出血的病理过程。