Changes And Clinical Significance Of TM,vWF,MMP-9 In Children With Henoch-Schonlein Purpura

Objective Henoch-Schonlein purpura is one kind of small vasculitis resulting in autoimmune reaction.During the pathologic damage the vascular endothelium were the target organ and the damage of extracellular matrix also play an important role.By investigate the levels plasma thrombomodulin(TM),von willebrand factor(vWF),matrix metalloproteinase-9(MMp-9) in children with Henoch-Schonlein purpura the thesis explors the function they play in the pathogenesis of HSP,analyses the correlation with its renal damage and searches for the index of the early lesion of renal function.Methods The plasma concentration of TM,vWF,MMP-9 were measured by enzyme-linked immunosorbent assay(ELISA) method in 46 acute SHP patients,40 recovery patients and 20 healthy controls and compare the levels between the renal damage group and non-renal damage group.Results The plasma levels of TM,vWF,MMP-9 in acute phase were significantly higher than those in healthy controls(P＜0.01) and also higher than those during recovery period(P＜0.05).The plasma levels of MMP-9 droped back slowly and their levels during recovery period were still higher than those in healthy controls(P=0.01).The plasma levels of TM,MMP-9 were higher in renal damage group than in non-renal damage group (P＜0.05),Whereas the plasma levels of TM have no significant difference between them(P＞0.05).The plasma levels of TM showed positive correlation with the level of vWF.But The plasma levels of TM and vWF showed no correlation with the level of MMP-9.Conclusions The plasma levels of TM,vWF,MMP-9 in acute phase were significantly higher than those in healthy controls which supported that the damage of vascular endothelium and extracellular matrix may participate in the pathogenesis of HSP.The results that the plasma levels of TM,vWF droped to normal levels during recovery period suggest that the levels of TM,vWF were correlated with the activity of HSP.The levels of MMP-9 during recovery period were still higher than those in healthy controls which suggested that with the recovery of the disease the damage of vascular endothelium stopped but the damage of extracellular matrix was going on.The high levels of plasma vWF,MMP-9 in acute phase and the persistence of abnormality of MMP-9 during the remission may be associated with the lesion of renal function.Changes of vWF,MMP-9 can be used as an index of the early lesion of renal function.