FIB,DD和FDP在高血压肾损伤中的变化及临床意义

Changes and Clinical Significance Observation on FIB,DD and FDP in Renal Impairment of Hypertension

目的研究纤维蛋白原（FIB）、D二聚体（DD）、纤维蛋白原降解产物（FDP）在高血压肾损伤中的变化及临床意义。方法选取145例原发性高血压患者作为病例组，按24h尿微量清蛋白（24hU—mALB）分为正常蛋白尿组、微量蛋白尿组及大量蛋白尿组；选取同期查体的健康人44例作为正常对照组。检测各组尿素氮（BUN）、胱抑素C（Cys—C）、尿酸（UA），FIB，DD和FDP，通过统计观察其差异及相关性。结果①BuN，Cys—C，UA，FIB，DD和FDP在四组间比较，差异具有统计学意义（P〈0．05）。正常蛋白尿组（DD，FDP），微量蛋白尿组（BUN，Cys—C，FIB，DD和FDP）及大量蛋白尿组（BUN，Cys—C，FIB，DD和FDP）与正常对照组比较，差异均具有统计学意义（Z=2．798，3．077，2．148，4．158，3．243，3．298，3．669，3．663，6．678，5．925，4．432和4．507，P〈0．05）；微量蛋白尿组（BUN，Cys-C，FIB）及大量蛋白尿组（BUN，Cys—C，FIB，DD和FDP）与正常蛋白尿组比较，差异均具有统计学意义（Z=2．510，4．233，2．302，4．090，6．678，5．266，2．736和2．709，P〈0．05）；大量蛋白尿组（BUN，Cys—C，FIB）与微量蛋白尿组比较，差异具有统计学意义（Z=2．355，3．587和3．839，P〈0．05）；微量蛋白尿组和大量蛋白尿组与其他各组比较，UA的差异均有统计学意义（P〈0．05）。②相关性分析：FIB与24hU—rnALB，BUN，Cys—C和UA呈正相关（r=0．462，0．252，0．411和0．183，P〈0．05）；DD与24hU—InALB，BUN和Cys—C呈正相关（r=0．194，0．286和0．346，P〈0．05）；FDP与24hU-mALB，BUN和Cys—C呈正相关（r=0．197，0．239和0．322，P〈0．05）。结论FIB，DD和FDP在高血压肾病早期和进展期表现出不同程度的升高，能够为临床及时发现病情进展提供一定的帮助。

Objective To study the changes and clinical significance of coagulation-related parameters in renal injury of patients with hypertension. Methods 145 patients with essential hypertension were selected as the case group. Divided the case group into normal,microand massive proteinuria group according to the content of 24 hours urinary micro albumin （24hU- mALB）. At the same time, 44 healthy persons were selected as the contrast group. Cystatin C （Cys-C）, uric acid （UA）, urea nitrogen （BUN）, fibri-nogen （FIB）,D-Dimer （DD） and fibrinogen degradation products （FDP） were detected in every sample. Finding the difference and correlation by statistical analysis in each group to observe the changes and effects on FIB,DD and FDP in renal impairment of hypertension. Results （1）BUN,Cys-C,UA,FIB,DD and FDP in the comparison between the four groups, the difference appeared statistical significance （P〈0. 05）. Compared with the contrast group, the statistical difference was found in DD,FDP of the normal proteinuria group, BUN, Cys-C, FIB, DD and FDP of the micro proteinuria group,and BUN,Cys-C,FIB,DD and FDP of the massive proteinuria group （Z=2. 798,3. 077,2. 148,4. 158,3. 243,3. 298, 3. 669,3. 663,6. 678,5. 925,4. 432 and 4. 507, all P〈 0.05）. Compared with the no-rmal proteinuria group, the statistical difference was showed in BUN, Cys-C and FIB of the micro proteinuria group, and BUN, Cys-C, FIB, DD, FDP of the massive proteinuria group （Z=2. 510,4. 233,2. 302,4. 090,6. 678,5. 266,2. 736 and 2. 709,all P〈0.05）. Compared with the micro proteinuria group,BUN,Cys-C and FIB in the massive proteinuria group appeared obviously statistical significance （Z=2. 355,3. 587 and 3. 839 ,all P〈0. 05）. Each of the micro proteinuria group and massive proteinuria group compared with the other groups,UA showed obviously statistical significance （P〈0.05）. （2）Correlation analysis： FIB was positively related to 24hU-mALB,BUN,Cys-C,UA （r=0. 462,0. 252,0. 411,0. 183,all P〈0. 05）. DD was positively related to 24hU-mALB,BUN,Cys-C （r=0. 194,0. 286,0. 346,all P〈0.05）. FDP was positively related to 24hU-mALB,BUN,Cys-C （r=0. 197, 0. 239,0. 322,all P〈0.05）. Conclusion FIB,DD and FDP could show different changes both in early and advanced stage of renal injury with hypertension, which can provide some help for the clinical diagnosis of disease.