Dymicka-Piekarska Violetta, Matowicka-Karna Joanna, Mantur Maria, Kemona Halina, Piszka Jerzy
Zaklad Laboratoryjnej Diagnostyki Klinicznej Akademii Medycznej, 15-274 Białystok, ul. Waszyngtona 15A.
Przegl Lek. 2002;59(12):980-3.
Patients with uremia show a tendency for hemorrhagic diathesis and thrombi formation. These disorders have been attributed to functional abnormalities of platelet and their interaction with the vascular wall. The aim of the present study was to elucidate whether and how in patients with uremia, hemodialysis affects the level of platelet activation markers, i.e.: beta-TG and PF4, and whether the changes in the examined parameters depend on creatinine level and on the type dialysis membranes used during HD. The study involved 70 patients with uremia subjected to repeated hemodialysis and 70 healthy subjects. Prior to HD, we observed a decrease in PLT, and increase in beta-TG concentration and a drop in PF4 (p = 0.000), compared to control group. Immediately after the procedure a significant increase was observed in PLT and decrease in PF4 concentration, as well as a slight rise in beta-TG level, compared to the values obtained before HD. We also found statistically significant differences in beta-TG and PF4 concentrations prior to HD, irrespective of creatinine concentration, compared to control group. Only at creatinine concentration of 10.0-15.5 mg/dL, PLT differences significantly from PLT in control group. Following HD, creatinine-dependent statistically significant changes were noted in PLT, in comparison to the values obtained before the procedure. The analysis of platelet parameters revealed no statistically significant differences associated with the type of the dialysis membrane used for HD.
尿毒症患者有出血倾向和血栓形成的趋势。这些病症归因于血小板的功能异常及其与血管壁的相互作用。本研究的目的是阐明在尿毒症患者中,血液透析是否以及如何影响血小板活化标志物的水平,即β-血小板球蛋白(β-TG)和血小板第4因子(PF4),以及所检测参数的变化是否取决于肌酐水平和血液透析期间使用的透析膜类型。该研究纳入了70例接受反复血液透析的尿毒症患者和70名健康受试者。与对照组相比,在血液透析前,我们观察到血小板(PLT)减少,β-TG浓度升高,PF4下降(p = 0.000)。与血液透析前获得的值相比,在该操作后立即观察到PLT显著增加,PF4浓度降低,以及β-TG水平略有上升。我们还发现,与对照组相比,无论肌酐浓度如何,血液透析前β-TG和PF4浓度存在统计学显著差异。仅在肌酐浓度为10.0 - 15.5mg/dL时,PLT与对照组的PLT有显著差异。血液透析后,与操作前获得的值相比,PLT出现了与肌酐相关的统计学显著变化。血小板参数分析显示,与用于血液透析的透析膜类型无关的统计学显著差异。