论文部分内容阅读
目的:探讨狼疮样抗凝物质(LA)与慢性肾脏疾病患者凝血功能变化的关系。方法:采用血浆蝰蛇毒时间测定170例慢性肾脏疾病患者LA比值,其中肾病综合征患者29例(NS组)、慢性肾小球肾炎患者38例(CGN组)、慢性肾功能不全代偿期患者40例(CRC组)、慢性肾功能不全失代偿期患者31例(CRD组)、慢性肾功能衰竭期患者32例(CRF组),同时采用免疫比浊法测定血浆D二聚体(D-D)及凝固法测定纤维蛋白原(FIB)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)。并与30例健康对照者(对照组)及各组间进行比较分析。结果:CRC组LA比值(1.05±0.06)、D-D(0.96±0.29)、FIB(3.36±0.92),CRD组LA比值(1.12±0.08)、D-D(1.51±0.62)、FIB(4.01±1.03),CRF组LA比值(1.18±0.09)、D-D(2.63±1.20)、FIB(4.75±1.74),差异有统计学意义(Р均<0.05),以CRF组的上述各参数变化最为显著;CGN组LA比值(1.07±0.06)、D-D(1.21±0.55)、FIB(3.32±0.85)、PT(13.2±0.8),NS组LA比值(1.13±0.09)、D-D(2.53±1.10)、FIB(5.19±1.93)、PT(12.5±0.5),差异有统计学意义(Р均<0.05);慢性肾脏疾病各组的LA比值、D-D和FIB含量与对照组LA比值(1.00±0.05)、D-D(0.39±0.10)、FIB(2.95±0.59)比较,差别有统计学意义(Р均<0.05)。结论:慢性肾脏疾病患者体内凝血功能的紊乱表现随着病情的加重越明显,且LA比值的增加与高凝状态及病变严重性相平行,LA可能是引起慢性肾脏疾病患者体内血液凝固性增高的原因之一。
Objective: To investigate the relationship between lupus-like anticoagulant (LA) and coagulation function in patients with chronic kidney disease. Methods: The LA ratio of 170 patients with chronic kidney disease was determined by plasma viper venom time, including 29 patients with nephrotic syndrome (NS group), 38 patients with chronic glomerulonephritis (CGN group), compensated patients with chronic renal insufficiency 40 cases (CRC group), 31 cases of decompensated chronic renal insufficiency (CRD group) and 32 cases of chronic renal failure (CRF group). Meanwhile, the level of plasma D-dimer (DD ) And coagulation method for determination of fibrinogen (FIB), prothrombin time (PT), activated partial thromboplastin time (APTT). And 30 healthy controls (control group) and the comparison between the groups. RESULTS: The LA ratio (1.05 ± 0.06), DD (0.96 ± 0.29), FIB (3.36 ± 0.92), LA ratio (1.12 ± 0.08), DD (1.51 ± 0.62), FIB CRF group LA ratio (1.18 ± 0.09), DD (2.63 ± 1.20), FIB (4.75 ± 1.74), the difference was statistically significant (Р all <0.05), CRF group the most significant changes in the above parameters; CGN group LA (1.07 ± 0.06), DD (1.21 ± 0.55), FIB (3.32 ± 0.85), PT (13.2 ± 0.8), NS group LA ratio (1.13 ± 0.09), DD (2.53 ± 1.10) and FIB ) And PT (12.5 ± 0.5). There was significant difference between the two groups (P0.05). LA ratio, DD and FIB contents in chronic kidney disease group were significantly higher than those in control group (1.00 ± 0.05), DD ), FIB (2.95 ± 0.59), the difference was statistically significant (Р all <0.05). Conclusion: In patients with chronic kidney disease, the disturbance of coagulation function is more obvious with the aggravation of the disease. The increase of LA ratio parallels the hypercoagulability state and the severity of the disease. LA may be the cause of increased blood coagulation in patients with chronic kidney disease one of the reasons.