慢性肾小球疾病高凝血症的研究

Studies on the Hypercoagulability in Patients with Chronic Glomerular Diseases

目的 :探讨慢性肾小球疾病凝血学异常。方法 :选择反映凝血、抗凝及纤溶异常的有关指标进行检测。结果 :与健康人比较 ,慢性肾炎及肾病综合征患者血浆凝血酶原活性、凝血酶活性及纤维蛋白原含量均明显增高 ,P<0 .0 5～ 0 .0 1,纤溶酶原活性明显降低 ,P<0 .0 1。结论 :慢性肾小球疾病均存在不同程度的高凝血症继发性纤溶增强。高凝血症主要是凝血因子增加而抗凝血因子并不降低 ,高脂蛋白 ( a)及低蛋白血症是高凝血症的重要原因 ,糖皮质激素加重高凝血症 ,而且抑制纤溶活性。

Objective:To explore the abnormal coagulation status in patients with Chronic glomerular diseases.Methods:Detections were made related to the blood coagulation,antocoagulation and plasminogen.Results:Compared with the normal cases,the raised levels of prothrombin,thrombin and fibrinogen were observed in cases with chronic nephritis and nephrotic syndrome( P <0.05～ 0.01 ).The plasminogen activity was significantly raised ( P <0.01).Conclusions:Hypercoagulation complicated with raised plasminogen existed in the cases with chronic glomerular diseases.The hypercoagulation was characterized wth increased coagulation factors while the anticoagulation factors were not lowered.The main causes of the hypercoagulation status was due to hyperlipoprotein (a) and hypoproteinemia.Glucocorticoid could worsen the hypercoagulation status and inhibit the plasminogen.