移植肾静脉血中抗凝血酶Ⅲ、D-二聚体和血小板聚集率的变化

Changes of antithrombin Ⅲ actirity, D-dimer content and platelet aggregation rate in venous blood of transplanted kidney

目的:观察移植肾在动脉开放后其静脉血中有无高凝状态以及与血栓形成的关系。方法:19例行肾移植术病人,术前采取桡动脉血标本为对照;肾动脉开放后5分钟和输尿管吻合后5分钟各采取肾静脉血,分别测定抗凝血酶Ⅲ(AT-Ⅲ)活性、D-二聚体(D-D)含量及血小板最大聚集率。结果:桡动脉血AT-Ⅲ活性和D-D含量接近正常,肾静脉血D-D含量与术前桡动脉血值相比无显著差异,而AT-Ⅲ活性值升高有非常显著的差异(P<0.01)。桡动脉血和肾静脉血血小板最大聚集率均高于正常值(P<0.01)。结论:移植肾静脉血呈高凝状态,抗凝活性升高,但纤溶活性无显著变化,提示有潜在的血栓形成的危险性。

Objective: To evaluate whether the venous blood of transplanted kidney was hypercoagulability or not. Method: Nineteen cases of patients with renal transplantation were enrolled. Blood samples of radial artery were taken preoperatively as control. Renal venous blood samples were taken 5 min after opening of renal artery and 5 min after finish of ureter anastomosis. Antithrombin Ⅲ activity (AT-Ⅲ), content of D-dimer (D-D) and maximal platelet aggregation rate were determined respectively. Result: AT-Ⅲ and D-D values of radial artery blood were in normal range. D-D value of renal venous blood remained unchanged compared with that of radial arterial blood, but AT-Ⅲ level increased very significantly (P<0.01). Maximal platelet maximal aggregation rates of radial artery and renal venous blood were higher than normal value (P<0.01). Conclusion: Renal venous blood of transplanted kidney is hypereoagulability with high anticoagulability but without fibrinolysis, indicating the risk of potential thrombosis.