肾移植患者移植前后纤溶功能变化观察

Observation of Fibrinolytic function change in patients with Renal Transplantation before and after engrafting

目的:肾移植的排斥反应易导致纤溶功能改变,本文旨在探讨肾移植患者移植前后的纤溶改变的机理及临床意义。方法:20例患者手术前、后一天、三天、一周分测①t-PA、②PAI:A、③PLG:A、④PLM:A、均为发色底物法⑤D-Dimer ELLSA法。结果:[1]患者术前①②③④项较正常组差异明显;[2]患者术后三次②⑤明显高于正常组和术前[3]患者术后第三天除D二聚体外,其余均较第一天、一周结果相差显著。结论:重型肾病本身易形成血栓,术前亦可见局限性纤溶活性增强。肾移植之排斥反应亦可导致血栓形成,致继发性纤溶元进,定期检测有利于了解排斥反应的出现时间与严重程度,以便及早采取措施.提高移植的成功率。

Objective: To investigate the mechanism and clinical significance of fibrinolytic change in patients with renal transplantation (RT) before and after engrafting. Methods: tPA, PAI:A, PLG:A,PLM:A and D-Dimer were dynamic measured in patients with RT. Results: 1. As compared with normal controls, the ①②③④ parameters intentioned above were different obviously in the patients preoperatively; 2. PAI: A and D -Dimer were significantly higher in postoperation than those in controls and preoperan'on; 3. tPA, PAI: A, PLG: A and PLM: A were diferent obviously in the third day compared with the first and seventh day after operation. Conclusion :Hyperfibrinolytic state is present in severe renal disorders and RT, wiich may be caused by hyper-coagulability and RT rejection, respectively. Therefore, dynamic obseration of these indexes may be of benefit to discover and treatment RT rejection.