过敏性紫癜儿童凝血纤溶系统异常与早期肾损伤的相关性

Correlation between abnormality of coagulation and fibrinolysis system and early renal injury in children with Henoch-Sch9nlein purpura

目的:探讨过敏性紫癜患儿凝血纤溶系统异常与早期肾损伤的相关性。方法:选取2018年1月至2020年10月我院收治的129例过敏性紫癜患儿为试验组,根据肾损伤与否分为紫癜性肾炎组(HSPN组,41例)和过敏性紫癜组(HSP组,88例),选取同期20例健康儿童为对照组。结果:HSP组与HSPN组D-二聚体(D-D)、纤维蛋白原(FIB)、纤维蛋白降解产物(FDP)均高于对照组(P<0.05)。D-D、FIB、FDP与尿微量白蛋白的相关性均较低(r=0.074、0.141、0.130,P>0.05)。尿微量白蛋白、D-D、FIB、FDP诊断紫癜性肾炎的ROC曲线下面积分别为0.99、0.55、0.37、0.40。结论:过敏性紫癜会引起凝血纤溶系统功能异常。紫癜性肾炎患儿可能存在更严重的继发性纤溶亢进及肾损伤,但尚不能以凝血纤溶指标升高作为紫癜性肾炎发生的预测依据。

Objective:To explore the correlation between abnormality of coagulation and fibrinolysis system and early renal injury in children with Henoch-Sch9nlein purpura(HSP).Methods:129 HSP children treated in our hospital from January 2018 to October 2020 were selected as the experimental group.They were divided into HSP nephritis group(HSPN,41 cases)and HSP group(88 cases)according to whether their kidney was damaged or not.20 healthy children during the same period were selected as the control group.Results:The levels of D-Dimer(D-D),fibrinogen(FIB)and fibrin degradation products(FDP)in HSP group and HSPN group were significantly higher than those in the control group(P<0.05).The correlations between D-D,FIB,FDP and urinary microalbumin were all low(r=0.074,0.141,0.130,P>0.05).The areas under the ROC curve of urinary microalbumin,D-D,FIB and FDP in the diagnosis of HSPN were 0.99,0.55,0.37 and 0.40,respectively.Conclusion:HSP can cause abnormal function of coagulation and fibrinolysis system.HSPN Children may have more serious secondary hyperfibrinolysis and renal injury,but the increase of coagulation and fibrinolysis indexes can not be used as a predictor of the occurrence of HSPN.