Ueda N, Kawaguchi S, Niinomi Y, Nonoda T, Matsumoto J, Ohnishi M, Yasaki T
Department of Pediatrics, Fujita Gakuen Health University, School of Medicine, Aichi, Japan.
Pediatr Nephrol. 1987 Jul;1(3):286-9. doi: 10.1007/BF00849225.
Prothrombin time (PT), activated partial thromboplastin time (APTT) and plasma procoagulant activities were studied in 38 children with nephrotic syndrome in the presence or absence of prednisolone therapy. PT was normal but APTT was prolonged during relapse in untreated patients. Increased factors V, VII, VIII, XI and XIII in both treated and untreated and factor IX in treated patients, as well as decreased factors X and XII in untreated patients, were observed during relapse. These coagulation factor changes were unrelated either to the dose of prednisolone or underlying renal histology and normalized with clinical remission. However, plasma levels of factors II, V, VIII, IX, X and XI were still increased in treated patients. The data suggest that corticosteroids shorten APTT, raise both intrinsic and extrinsic factors, and therefore have favorable and unfavorable effects on the coagulation system in children with nephrotic syndrome.
在38例肾病综合征患儿中,研究了有无泼尼松龙治疗情况下的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)及血浆促凝血活性。未经治疗的患者在疾病复发期间PT正常,但APTT延长。在复发期间,观察到无论是接受治疗还是未接受治疗的患者,其因子V、VII、VIII、XI和XIII均升高,接受治疗的患者因子IX升高,而未接受治疗的患者因子X和XII降低。这些凝血因子变化与泼尼松龙剂量或潜在的肾脏组织学均无关,且随着临床缓解而恢复正常。然而,接受治疗的患者血浆中因子II、V、VIII、IX、X和XI水平仍升高。数据表明,皮质类固醇可缩短APTT,升高内源性和外源性因子,因此对肾病综合征患儿的凝血系统有有利和不利影响。