原发性肾病综合征高凝状态相关因素之间的关系

目的研究成人原发性肾病综合征(PNS)高凝状态相关因素之间的关系.方法选择肾病综合征患者60例,并取正常体检者40例作为对照者;同时测定血浆蛋白C(PC)含量、血常规、血白蛋白、血总蛋白、血脂、部分凝血及纤溶指标、BUN、Cr和24h尿蛋白定量.结果肾病综合征组的血TCH、TG、LDL、PC、24h尿蛋白定量、血BUN明显高于对照组(P<0.01),血白蛋白明显低于对照组(P<0.01);Hct、Hb、RBC、PLT、血PT、PT-INR、TT及Fg两者也有显著性差异(P<0.01).血PC与TCH、Fg、TG、Hct、RBC、Hb呈正相关(分别P<0.01和P<0.05),而与血白蛋白呈负相关(P<0.05);尿白蛋白与TCH、Hct、APTT、Fg和PT、PT-INR呈正相关(P<0.01及P<0.05),而与血白蛋白呈负相关(P<0.05).结论肾病综合征患者血液的高凝状态与继发性高脂血症、凝血系统被激活所造成的凝血功能亢进、血小板增多、血液浓缩等多种因素有关.

The relationship of factors correlated with hypercoagulable state in patients with nephrotic syndrome

Objective To study the relationship of factors correlated with hypercoagulable state in patients with nephrotic syndrome.Methods 60 patients with nephrotic syndrome(nephrotic group) and 40 healthy(control group) were chosen.Serum protein C(PC),blood routine,albumin,lipid,partial indexes of coagulation and fibrinolysis,BUN,Cr and proteinuria in 24 hours were tested.Results The level of blood TCH,TG,LDL,PC,and proteinuria in 24h and BUN in NS group were higher than those in control(P<0.01);and the level of Hct,Fg,Hb,RBC,PLT,PT,PT-INR,TT were different between the two groups(P<0.01).PC was correlated with TCH,Fg,Hct,RBC,Hb positively(each P<0.01,P<0.05)and with blood albumin negatively(P<0.01);urine albumin has a positive correlation with TCH,Hct,APTT,Fg,PT and PT-INR(P<0.01,P<(0.05),respectively) and negative with blood albumin(P<0.05).Conclusion Hypercoagulability in patients with NS was affected by such factors as secondary hyperlipidemia,hypercoagulable function caused by actived coagulable system,thrombocytosis,blood concentration and so on.