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[肾病综合征患者的高凝状态]

[Hypercoagulation in patients with nephrotic syndrome].

作者信息

Zdrojewski Z, Raszeja-Specht A, Skibowska A, Owczarzak A, Rutkowski B

机构信息

Kliniki Chorób Nerek Instytutu Chorób Wewnetrznych, Gdańsku.

出版信息

Pol Merkur Lekarski. 1997 Jan;2(9):201-4.

Abstract

Hypercoagulation and thrombotic complications associated with nephrotic syndrome (NS) are known from many years. However pathomechanism of those disturbances is not very clear. The aim of the presented study was to determine the role of platelets in hypercoagulation phenomenon in NS patients. Studies were carried out in 15 patients with NS in the course of chronic glomerulonephritis and 15 healthy volunteers. Following parameters were estimated: prothrombin, time APTT, fibrinogen, FDP, plasminogen, antithrombin III, alpha 2-antiplasmin and using Technicon H1 autoanalyser: platelet count (PLT), mean platelet volume (MPV) and PLT Mode. Additionally platelets aggregation (spontaneous and after collagen, epinephrine, ADP) was measured using Apact (Labor) aggregometer. We observed in patients with NS: a) decrease of AT III, b) slight increase (not significant) of fibrinogen, c) decrease of MPV and Mode PLT, d) increased spontaneous aggregation and sensitivity to aggregating agents. Our results suggest that: 1. Pathomechanism of hypercoagulation in NS is multifactorial. 2. Changes in morphology and function of platelets could be one of the factor playing important role in this mechanism.

摘要

多年来,人们已经知晓与肾病综合征(NS)相关的高凝状态和血栓形成并发症。然而,这些紊乱的发病机制尚不完全清楚。本研究的目的是确定血小板在NS患者高凝现象中的作用。对15例慢性肾小球肾炎病程中的NS患者和15名健康志愿者进行了研究。评估了以下参数:凝血酶原、活化部分凝血活酶时间(APTT)、纤维蛋白原、纤维蛋白降解产物(FDP)、纤溶酶原、抗凝血酶III、α2-抗纤溶酶,并使用Technicon H1自动分析仪检测:血小板计数(PLT)、平均血小板体积(MPV)和血小板模式(PLT Mode)。此外,使用Apact(Labor)凝集仪测量血小板聚集(自发性以及在胶原、肾上腺素、二磷酸腺苷作用后的聚集)。我们在NS患者中观察到:a)抗凝血酶III降低,b)纤维蛋白原轻度升高(不显著),c)MPV和血小板模式降低,d)自发性聚集增加以及对聚集剂的敏感性增加。我们的结果表明:1. NS中高凝的发病机制是多因素的。2. 血小板形态和功能的改变可能是该机制中起重要作用的因素之一。

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