小儿肾病综合征D-二聚体和抗凝血酶-Ⅲ的检测及意义

The detection and clinical implications of D-dimer and AT- Ⅲ in plasma of children with nephroti~ syndrome

目的观察小儿肾病综合征凝血系统功能紊乱情况。方法检测26例肾病综合征患儿血浆凝血指标、D-二聚体（D-dimer）含量以及AT-Ⅲ活性，同时检测20例健康儿童作为正常对照。结果（1）肾病综合征发作期D-dimer含量为（0．91±0．36）mg／L，AT-Ⅲ活性为（57．6±19．8）％；缓解期分别为（0．32±0．10）mg／L，（75．4±21．1）％；正常对照组分别为（0．43±0．16）mg／L，（89．2±16．6）％。（2）肾病综合征发作期较对照组D-dimer含量明显升高（P〈0．01），AT-Ⅲ活性明显降低（P〈0．01）。（3）肾病综合征合并高凝状态发生率为46％，DIC的发生率为8％。结论肾病综合征患儿具有凝血、纤溶功能异常，DIC为其表现之一。

Objective To investigate the clotting system disfunction of nephrotic syndrome （NS）. Methods The plasma clotting index, D-dimer concentration and antithrombin 11/ （AT-Ⅲ ） activity of 26 children with NS were detected, in the meantime, 20 healthy children served as control. Results （1） On onset of NS, the D-dimer was （0.91 ± 0.36） mg/L, AT- Ⅲ was （ 57.6 ±19.8 ） % ; in remission period, D-dimer was （0.32 ± 0.10） mg/L, AT- Ⅲ was （75.4 ± 21.1） % ;the control group was （0.43 ± 0.16） mg/L and （89.2 ± 16.6） %, respectively. （2） D-dimer concentration of NS children in period of onset was obviously higher than that of control group （P〈0.01）,AT-Ⅲ was obviously lower than that of control group （P〈0.01）. （3） The incidence rate of hypercoagulabihty states was 46 % and DIC was 8 % in NS children. Conclusion The children who suffer from NS have the disfunction of blood clotting system and fibrolysis system. DIC is one of its manifestations.