论文部分内容阅读
目的 研究肾病综合征 (NS)高凝状态所致深静脉血栓形成 (DVT)和肺栓塞 (PE)的发生率 ,抗凝治疗的指征和临床效果。方法 5 4例NS患者 ,男性 31例 ,女性 2 3例 ;平均年龄 (44 13± 15 88)岁 ,2 4小时尿蛋白 (8 4 3± 5 6 4 ) g ,血浆白蛋白 (2 0 4 8± 5 4 1) g/L。采用巨聚合人血清白蛋白 (99mTc -MAA)核素深静脉造影(RNV)及肺显像诊断下肢DVT和PE ,并评价低分子量肝素 (LMWH)皮下注射和口服抗血小板凝集药物治疗的临床效果。结果 诊断下肢DVT4 1/5 4例 ,占 76 % ,有临床表现者占 14 8% ;PE 32 /5 4例 ,占 5 9 2 5 % ,有临床症状者占 7 4 %。PE由下肢DVT引起的占 70 7%。经LMWH治疗后 ,无 1例患者死于肺栓塞。结论 DVT是NS最重要的并发症之一 ,RNV能早期诊断下肢DVT和PE ,尽早抗凝治疗能改善NS的预后 ,降低PE的病死率
Objective To investigate the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients with nephrotic syndrome (NS) hypercoagulable state, and the indications and clinical effects of anticoagulant therapy. METHODS: Twenty-four patients with NS were enrolled in this study. There were 31 males and 23 females with an average age of (44 13 ± 15 88) years, 24 hours urinary protein (843 ± 564) g and plasma albumin 8 ± 5 4 1) g / L. The clinical effects of subcutaneous injection of low molecular weight heparin (LMWH) and oral anti-platelet aggregation drug were evaluated by deep venous angiography (RNM) and pulmonary imaging of giant polymeric human serum albumin (99mTc-MAA) . Results The diagnosis of lower extremity DVT4 1/5 4 cases, accounting for 76%, with clinical manifestations accounted for 14 8%; PE 32/54 4 cases, accounting for 5 925%, clinical symptoms accounted for 74%. PE caused by lower extremity DVT accounted for 70 7%. None of the patients died of pulmonary embolism after LMWH treatment. Conclusions DVT is one of the most important complication of NS. RNV can early diagnose DVT and PE of lower extremities. As soon as possible, anticoagulant therapy can improve the prognosis of NS and reduce the mortality of PE