维持性血液透析患者发生凝血的危险因素分析及其凝血功能变化的临床价值

Analysis of Risk Factors of Coagulation of Patients with Maintenance Hemodialysis and Clinical Value of Coagulation Function Changes

目的探究维持性血液透析患者出现凝血的危险因素及凝血功能变化情况。方法选取该院2016年9月—2017年9月收治的70例维持性血液透析患者临床资料进行分析,将其设为研究组,并取同期健康体检正常者70名作对照组,针对研究组患者行维持性血液透析治疗,观察研究组凝血发生的危险因素,比较两组凝血功能指标水平。结果研究组透析后FIB(2.16±0.31)g/L、PT(10.23±0.54)s等凝血指标水平与透析前及对照组比较均差异有统计学意义(t=14.745 3,36.600 3,23.551 1,18.8967,P<0.05);研究组透析后D-D(1 102.21±216.39)μg/L、hs-CRP(6.88±1.41)mg/L均高于透析前(t=10.669 3,6.667 6,P<0.05);研究组凝血发生因素中以高脂饮食21.42%所占比重最高,但与抗凝不当、血液高凝状态发生率差异无统计学意义(P>0.05)。结论维持性血液透析患者透析后凝血功能指标水平与正常人群具显著差异,其凝血发生多与高脂饮食、抗凝不当等相关,临床可据此予以早期预防,促患者预后改善。

Objective To study the risk factors of coagulation of patients with maintenance hemodialysis and clinical value of coagulation function changes.Methods 70 cases of patients with maintenance hemodialysis admitted and treated in our hospital from September 2016 to September 2017 were selected as the research group,while 70 cases of healthy physical examination people at the same period were selected as the control group,and the research group were treated with maintenance hemodialysis,and the occurrence risk factors of coagulation in the research group was observed,and the level of coagulation function was compared between the two groups.Results The FIB and PT after hemodialysis in the research group were respectively(2.16±0.31)g/L and(10.23±0.54)s,and the differences were statistically significant(t=14.745 3,36.600 3,23.551 1,18.896 7,P<0.05);after the hemodialysis,the D-D and hs-CRP in the research group were respectively(1 102.21±216.39)μg/L and(6.88±1.41)mg/L,which were higher than those before hemodialysis(t=10.669 3,6.667 6,P<0.05),and the ratio of high fat diet was the highest,accounting for 21.42%in the research group,and the differences compared with the incidence rates of improper coagulation and hypercoagulability state were not obvious(P>0.05).Conclusion The differences in the levels of coagulation function indicators after the hemodialysis between the patients with maintenance hemodialysis and normal people are obvious,and the levels of coagulation function indicators are related to the high fat diet and improper coagulation,and we should conduct the early prevention to promote the improvement of prognosis of patients in clinic.