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目的探讨高原和平原原发性肾病综合征(nephrotic syndrome,NS)患者凝血功能指标的差异,为高原NS患者的诊治提供参考依据。方法以健康体检者为正常对照组(n=30),同期检测西藏军区总医院(高原组,n=30)和第三军医大学新桥医院肾内科(平原组,n=30)NS患者凝血酶原(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)、D-二聚体(D-Dimer)和血浆抗凝血酶Ⅲ(AT-Ⅲ)活性等指标,并对各组凝血抗凝指标的检验结果进行对比分析。结果与对照组相比,两组NS患者的PT、APTT均无显著差异(P>0.05),但Fib和D-D显著增高(P<0.01),AT-Ⅲ活性显著降低(P<0.01)。两组NS患者间相比,高原NS患者的Fib和D-D均显著高于平原NS组(P<0.01),而AT-Ⅲ活性明显低于平原NS组(P<0.01)。结论高原NS患者凝血活性较平原NS患者强,提示高原NS患者更需抗凝治疗。
Objective To investigate the difference of coagulation parameters in patients with nephrotic syndrome (NS) in plateau and plain, and to provide reference for the diagnosis and treatment of NS patients. Methods The healthy subjects were selected as the normal control group (n = 30). The same period, the coagulation tests were performed in the General Hospital of Tibet Military Region (Plateau group, n = 30) and NS Department of Nephrology (Plains group, n = 30) PT, APTT, Fib, D-Dimer and AT-Ⅲ activity were measured and analyzed. The coagulation and anticoagulation indicators of the test results were compared. Results Compared with the control group, there was no significant difference in PT and APTT between the two groups of NS patients (P> 0.05), but Fib and D-D were significantly increased (P <0.01) and AT-Ⅲ activity was significantly decreased (P <0.01). Fib and D-D in NS patients were significantly higher than those in plain NS patients (P <0.01), while AT-III activity was significantly lower in NS patients than in NS patients (P <0.01). Conclusion The platelet NS patients with coagulation activity than NS plain patients, suggesting that patients with high altitude NS need anticoagulant therapy.