摘要
目的观察维持性血液透析(MHD)患者血浆凝血因子Ⅻ活性(FⅫ:C)及D-二聚体水平的变化,探讨凝血、纤溶的特点及血液透析过程对其影响。方法分别测定70例MHD患者(MHD组)在透析开始时和结束时的血浆FⅫ:C及D-二聚体水平,并与65例健康体检者(对照组)进行对照。结果透析前MHD组患者的血浆FⅫ:C水平为(127.6±37.2)%,高于对照组的(90.0±12.0)%,差异有统计学意义(t=5.52,P<0.01);透析结束时MHD组患者的血浆FⅫ:C水平为(84.3±19.7)%,低于透析前的水平,差异有统计学意义(t=7.58,P<0.01)。透析前MHD组患者的血浆D-二聚体水平为(1.09±1.07)mg/L,高于对照组的(0.35±0.09)mg/L,差异有统计学意义(t=4.11,P<0.01);透析结束时MHD组患者的血浆D-二聚体水平为(1.23±1.19)mg/L,高于透析前的水平,差异有统计学意义(t=7.50,P<0.01)。结论 MHD患者存在着高凝及继发纤溶状态,血液透析过程使其更加明显;血浆D-二聚体水平升高提示高凝继发纤溶存在;MHD患者FⅫ:C明显升高,血液透析过程会使血浆FⅫ:C下降。
Objective To investigate the effects of maintenance hemodialysis on fibrinolysis and coagulation.system through observing changes in the activity of plasma coagulation factor Ⅻ activity(FⅫ:C)as well as the level of D-dimmer in patients undergoing maintenance hemodialysis(MHD).Methods Pre-and post-hemodialysis(HD)levels of plasma FⅫ:C and D-dimmer were determined in 70 MHD patients(MHD group),and the results were compared with those in 65 healthy subjects(the control group).Results The Pre-HD levels of plasma FⅫ:C and D-dimmer were significantly higher in MHD group than in control group((127.6±37.2)% vs(90.0±12.0)% and(1.09±1.07)mg/L vs(0.35±0.09)mg/L,respectively)(P0.01).The plasma FⅫ:C significantly decreased after HD((84.3±19.7)% vs(127.6±37.2)%)(P0.01),and the plasma D-dimmer significantly increased after HD((1.23±1.19)mg/L vs(1.09±1.07)mg/L)(P0.01).Conclution The increased plasma D-dimmer level after HD suggests that HD aggravate the hyperfibrinolysis secondary to the hypercoagulable state in MHD patients.The level of plasmaFⅫ:C rises,in MHD patients,and decreases after HD.
出处
《中国全科医学》
CAS
CSCD
北大核心
2011年第11期1208-1210,共3页
Chinese General Practice