凝血系统及纤维蛋白溶解系统测定在肾病综合征中的意义

Clinical Significance of Coagulation Parameters and Fibrinolysis Parameters in Nephrotic Syndrome Patients

目的 :测定凝血、纤溶系统的部分项目以期探讨在肾病综合征 (NS)病人中的结果及意义。方法 :采用发色底物法测定纤溶酶原 (PLG)的活性、凝血酶原 (FII)、凝血酶 (FⅡa)、组织型纤溶酶原激活剂 (t PA)、组织型纤溶酶原激活剂抑制物 (PAI 1) ;采用ELISA法测定血小板a 颗粒膜蛋白 14 0 (GMP 14 0 )、纤维蛋白原降解产物 (FDP) ;采用免疫浊度法测定PLG含量、抗凝血酶Ⅲ (AT Ⅲ )等项目 ;结果 :肾病综合征病人的PLG活性、t PA较正常组低 ,有显著性差异 (P <0 .0 1) ,FⅡ、FDP、PLG含量、PAI 1较正常组高 ,有显著差异 (P <0 .0 1) ,而GMP 14 0与正常组相比无差异 (P >0 .0 5 ) ,同期观察了肾病综合征病人治疗好转前后的结果 ,显示治疗好转后PLG活性上升 ,FDP上升 ,PLG含量及AT Ⅲ下降。结论 :肾病综合征病人存在凝血亢进的同时纤溶也亢进 ,测定凝血和纤溶系统的一些项目可了解病情并利于治疗。

Objective:To investigate the clinical significance of coagulation parameters and fibrinolysis parameters in nephrotic syndrome(NS) patients.Methods:This study included 185 NS patients and 18 healthy control.The activities of plasminogen(PLG),prothrombin(FⅡ),thrombin(FⅡa),tissue type plasminogen activator(t-PA) and plasminogen activator inhibitor 1(PAI-1) were measured with chromogenic substances.Platelet alpha-granule membrane protein(GMP-140),Fbrin(ogen) degradation products(FDP) were measured with enzyme linked immunosorbent assay(ELISA).The concentration of PLG and antithrombin Ⅲ(AT-Ⅲ) were measured with immunoturbidimetry.Rusults:The activities of PLG and t-PA in NS patients were significantly decreased as compared to those of the control(P<0.01).The concentration of FⅡ,FDP,PLG and PAI-1 were singnificantly increased as compared to those of teh control(P<0.01).No significant difference in GMP-140 was found between the NS patients and the control(P>0.05).The activities of PLG and the concentration of FDP were higher,and the concentrations of PLG and AT-Ⅲ were lower in patients with effective therapy than in untreated patients.Conclusion:The results showed the increase of coagulability and hyperfibrinolysis in NS patients,and come parameters of coagulation and fibrinolysis can be used bs indexes of NS patient's condition and treatment.