透析对尿毒症患者凝血系统的影响

Changes of Coagulationary System of Patients with Uremia in Hemodialysis and Peritoneal Dial

目的观察尿毒症透析前患者组、血透(HD)组、腹透(CAPD)组凝血、纤溶功能的变化。方法采用ELISA法检测患者血浆TAT、D-二聚体水平,同时检测患者常规凝血项目(PT、APTT、TT、Fbg)。结果尿毒症患者透析前后TAT、D-二聚体水平均升高,以CAPD组升高尤为明显,患者透析前TT、APTT缩短,透析后APTT情况有所好转。结论尿毒症患者体内存在高凝继发高纤的状态,透析尤其是腹膜透析可加剧这种紊乱。TAT、D-二聚体的测定较常规凝血检查能更准确反映患者体内凝血、纤溶状态。

Objective To investigate coagulation and fibrinolysis on haemodialysis （HD）,continuous ambulatory peritoneal dialysis（CAPD） and uremia patients. Methods TAT,D-dimer were measured by ELISA. Results The plasma level of TAT,D-dimer were significant in HD,CAPD,uremia patients,they were most significant in CAPD patients. TT, APTT were significantly shortened in patients. Conclusion There are turbulence of coagulation and fibrinolysis in all patients,the prothrombotic state in CAPD patients are most sever in contrast with uremia and HD patients. The plasma of TAT,D-dimer are more significant than TT,APTT to reflect the state of patients.