肾病综合征血浆血栓球蛋白β、血小板因子4、纤维蛋白原、D-二聚体水平的临床意义

Clinical Significance of Plasma β -thromboglobulin, Platelet Factor 4, Fibrinogen, D-dimer Lvels on Nephrotic Syndrome

目的观察肾病综合征血浆血栓球蛋白β、血小板因子4、血浆纤维蛋白原及D-二聚体水平变化。方法分别测定35例肾病综合征（NS）患者治疗前后、32例慢性肾功能不全代偿期（CRF）患者治疗前、35名健康成年人血浆血栓球蛋白β（β-TG）、血小板因子4（PF4）、血浆纤维蛋白原（Fib）及D-二聚体水平（D-dimer），并予以统计分析。结果①NS组及CRF组治疗前患者β-TG、PF4、Fib、D-dimer均显著高于正常对照组（P〈0．01），NS组患者β-TG、PF4、Fib、D-dimer显著高于CRF组（P〈0．05）.②在糖皮质激素、血管紧张素转换酶抑制剂治疗基础上，予以低分子肝素、双嘧达莫治疗后NS组患者病情好转，β-TG、PF4、Fib、D-dimer显著下降（P〈0．05）。结论肾病综合征存在血小板异常活化、凝血纤溶异常，抗血小板、抗凝治疗是肾病综合征中的重要环节。

Objective To observe the changes of plasma β -thromboglobulin, platelet factor 4, fibrinogen, Ddimer levels on nephrotic syndrome.Methods The levels of plasma β-thromboglobulin（ β -TG）, platelet factor 4 （PF4）,fibrinogen（Fib） and D-dimer（D-D） in 35 patients with nephrotic syndrome before and after treatment, 32 patients with chronic renal failure in phase Ⅱ before treatment, 35 healthy controls were measured and analysed statistically.Results （1）The levels of plasma β -TG, PF4, Fib and D-D both in 35 patients with nephrotic syndrome before treatment and in 32 patients with chronic renal failure in phase Ⅱ before treatment significantly higher than those in healthy controls（P〈0.01）,all the levels in 35 patients with nephrotic syndrome before treatment are significantly higher than those in 32 patients with chronic renal failure in phase Ⅱ before treatment（P〈0.05）; （2） The levels of plasma β -TG,PF4,Fib and D-D in 35 patients with nephrotic syndrome were declined significantly after the treatment of low molecular weight heparin and dipyridamole based on therapy of corticosteroid and angiotensin converting enzyme inhibitor（P〈0.05）.Conclusion The therapy of anti-platelet and anticoagulation on nephrotic syndrome appears necessary because of the abnormal activation of platelet,coagulation and fibrinolysis.