Schrader J, Köstering H, Scheler F
Behring Inst Mitt. 1986 Feb(79):216-30.
This article deals with the clinical importance of antithrombin III (AT III) in renal disease. Patients with nephrotic syndrome demonstrates a high risk of thromboembolism. A renal AT III loss is an important pathogenetic factor in these events. Patients with serumalbumin below 2.0 g/dl are mostly endangered. In patients with acute oligoanuric renal failure low AT III-levels due to consumption were often found that lead to diminished protection against intravascular coagulation processes and can therefore contribute to progression of illness. An AT III-substitution may be of some benefit in these patients. Additionally AT III was given in patients with dialysis-dependent renal failure and low levels of AT III leading to a reduced incidence of thrombosis of the extracorporeal system. Unnecessary high doses were also avoided and a minimal heparinization could be performed more efficiently in bleeding risk patients. Furthermore, AT III-levels during renal transplantation and during organ rejection are reported.
本文探讨抗凝血酶III(AT III)在肾脏疾病中的临床重要性。肾病综合征患者有发生血栓栓塞的高风险。肾脏AT III丢失是这些事件中的一个重要致病因素。血清白蛋白低于2.0 g/dl的患者大多处于危险之中。在急性少尿性肾衰竭患者中,常发现由于消耗导致AT III水平降低,这会削弱对血管内凝血过程的保护作用,从而可能促使病情进展。AT III替代治疗可能对这些患者有益。此外,对于依赖透析的肾衰竭且AT III水平低的患者给予AT III,可降低体外系统血栓形成的发生率。还避免了不必要的高剂量,并能在有出血风险的患者中更有效地进行最小剂量肝素化。此外,还报告了肾移植期间及器官排斥反应期间的AT III水平。