儿童过敏性紫癜凝血状态改变及其机制探讨研究

THE FUNCTION OF COAGULATION IN CHILDREN WITH HEOCH-SCHONLEIN PURPRUA

为研究儿童过敏性紫癜 (HSP)凝血状态的改变及其机制。分析处于发病期及缓解期的过敏性紫癜患儿 ,检测凝血酶原时间比 (Prothrombintimerate ,PTR)、血浆D 二聚体 (D dimer)及组织因子途径抑制物 (TissueFactorPathwayInhibitor,TFPI)水平 ,并与正常对照组进行比较。结果 ,与健康儿童相比 ,不论发作组或缓解组 ,HSP儿童的PTR均未见明显异常改变 ,t=- 1 86 9,t =1 4 91 ,P >0 0 5,与正常组差异无统计学意义 ;发作组HSP儿童轿浆D 二聚体浓度明显升高 ,t =- 1 5 8,P <0 0 5;而缓解组HSP儿童血浆D 二聚体浓度下降并与正常对照组没有差异 ,t =- 1 94 8,P >0 0 5;发作组血浆TFPI含量明显高于对照组 ,t=1 2 1 1 ,P >0 0 5。结果表明 :HSP儿童凝血状态的特征是发病期间处于高凝状态 ,并随着病情缓解高凝状态可恢复正常 。

To study the function of coagulation in children with Henoch-Schonlein purpura (HSP). Methods: Of the 50 HSP children, twenty-six who had attack of the disease were divided into the episode group, the other tenty-four who were in silence of illness were the remission group . The plasma levels of prothrombin time rate (PTR)? D-dimer and tissue factor pathway inhibitor(TFPI) were determined and compared whith those of thirty normal control children. Results: Comparing with the control group, both the episode group and the the remission group had no changes in regard to the PTR, but the plasma levels of D-dimer and TFPI were higher in the episode group than those of the control, there were no significant difference in D-dimer and TFPI between the remission and the control group. Conclusion: The characteristic changes of coagulation in children who have attack of HSP is hypercoagulability, and it could return to normal in remission time. The TFPI may provide important role to protect children with HSP from overactive coagultion even disseminated inravascular coagulation.