凝血变化在SLE患者肾损害中的意义

Coagulative index changes in kidney damage in patients with SLE

目的探讨系统性红斑狼疮(SLE)患者肾损害时凝血指标的变化及意义。方法选取54例SLE患者为观察组,其中分为肾损害组29例,非肾损害组25例;检测血浆D-二聚体(D-Dimer,D-D)、纤维蛋白原降解产物(FDP)、血管性假性血友病因子抗原(VWF:Ag)、凝血酶调节蛋白(TM)、组织型纤溶酶激活物(t-PA)、纤维蛋白原(FIB)和血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)的水平,并作对比分析。结果 SLE组D-D、VWF:Ag、TM和t-PA明显高于对照组(P<0.01);肾损害组上述四项指标明显高于非肾损害组(P<0.01);与对照组比较,PT、APTT明显缩短(P<0.01);TT和FIB两项指标无统计学意义(P>0.05)。结论 D-D、VWF:Ag、TM、FDP和t-PA的水平变化与系统性红斑狼疮患者的肾损害明显关联,指标水平随着肾损害的加重而升高。

Objective To investigate the changes and significance of coagulative indexs of kidney damage in patients with systemic lupus erythematosus （SLE）. Methods A total of 54 patients with SLE in the observation group, the group of 29 cases of kidney damage, kidney damage group of 25 patients; plasma D-dimer （D-Dimer, D-D）, fibrinogen degra- dation product （FDP）, vascularvon Willebrand factor antigen （VWF： Ag）, thrombomodulin （TM）, tissue-type plasminogen activator （t-PA）, fibrinogen （FIB）, and the levels of prothrombin time （PT）, activated partial thromboplastin time （APTr） and thrombin time 0T） were detected and compared. Results SLE group DD, VWF： Ag, TM and t-PA were significantly higher （P 〈 0.01）; these four indicators of kidney damage group was also significantly higher than that of non-renal impairment group （P 〈 0.01）; Fq＇, APTY was significantly shorter （in comparison with the control group （P 〈 0.01）; however, for Tr and FIB, there were no significant differences between the two groups （P 〉 0.05）. Conclusion D-D, VWF： Ag, TM, FDP and t-PA levels in patients with SLE kidney were significantly associated with kidney damage. Further more, levels of these indicators were increased along with the severity of kidney damage.