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肾病综合征且白蛋白水平相对较高患者的血栓栓塞事件风险:一项超过 10 年的研究。

The risk of thromboembolic events in patients with nephrotic syndrome and relatively high albumin levels: a study over 10 years.

机构信息

Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China.

Key Laboratory of Renal Disease, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Ministry of Health of China, Beijing, China.

出版信息

BMC Nephrol. 2024 Sep 11;25(1):301. doi: 10.1186/s12882-024-03704-w.

Abstract

BACKGROUND

Low albumin level is a risk factor for thromboembolic events in patients with NS (nephrotic syndrome). However, little is known about the proportion and characteristics of patients with NS who experience thromboembolic events with relatively high albumin levels (≥ 25 g/L). Therefore, we explored the features of this specific group of patients.

METHODS

This study included all hospitalized patients in our center for the past 10 years who had diagnoses of NS and relevant thromboembolic events. We divided them into 2 groups based on their serum albumin level when the thromboembolic event occurred. The clinical data were analyzed with SPSS software.

RESULTS

There were 312 patients enrolled in our study. Eighty-four (26.9%) of them had relatively high albumin levels (≥ 25 g/L). Patients with NS with high albumin levels had significantly lower levels of 24-h proteinuria (P < 0.01) and a higher rate of autoimmune disease (P = 0.03) than the low-albumin group. Membranous nephropathy (MN) was the most frequent pathological type of NS in patients with thromboembolic events, regardless of their albumin level. There were significantly fewer patients with anti-PLA2R (M-type phospholipase A2 receptor)-positive MN in the high-albumin group than in the low-albumin group (P < 0.01).

CONCLUSIONS

Our study found that there was still a high risk for patients with NS and relatively high albumin levels to develop thromboembolic events.

摘要

背景

低白蛋白血症是肾病综合征(NS)患者发生血栓栓塞事件的危险因素。然而,对于白蛋白水平相对较高(≥25g/L)的 NS 患者发生血栓栓塞事件的比例和特征知之甚少。因此,我们探讨了这一特定人群的特征。

方法

本研究纳入了过去 10 年来在我院住院的所有诊断为 NS 且发生过相关血栓栓塞事件的患者。我们根据血栓栓塞事件发生时的血清白蛋白水平将其分为 2 组。采用 SPSS 软件对临床资料进行分析。

结果

本研究共纳入 312 例患者,其中 84 例(26.9%)白蛋白水平相对较高(≥25g/L)。与低白蛋白组相比,高白蛋白组 NS 患者的 24 小时尿蛋白定量显著降低(P<0.01),自身免疫性疾病的发生率更高(P=0.03)。膜性肾病(MN)是血栓栓塞事件患者中最常见的 NS 病理类型,无论其白蛋白水平如何。高白蛋白组抗 PLA2R(M 型磷脂酶 A2 受体)阳性 MN 患者明显少于低白蛋白组(P<0.01)。

结论

本研究发现,白蛋白水平相对较高的 NS 患者仍存在发生血栓栓塞事件的高风险。

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[Thromboembolic complications in nephrotic syndrome].[肾病综合征中的血栓栓塞并发症]
Dtsch Med Wochenschr. 2013 May;138(21):1123-9. doi: 10.1055/s-0033-1343113. Epub 2013 May 15.

本文引用的文献

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Renal Involvement in Antiphospholipid Syndrome.抗磷脂综合征的肾脏受累。
Front Immunol. 2018 May 17;9:1008. doi: 10.3389/fimmu.2018.01008. eCollection 2018.
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Renal involvement in antiphospholipid syndrome.抗磷脂综合征的肾脏受累。
Nat Rev Nephrol. 2014 May;10(5):279-89. doi: 10.1038/nrneph.2014.38. Epub 2014 Mar 18.

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