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尿纤维蛋白降解产物的诊断价值

Diagnostic value of urinary fibrin degradation products.

作者信息

Schmitt E, Seyfarth M, Templin R, Schneider P, Klinkmann H

出版信息

Nephron. 1980;25(1):25-9. doi: 10.1159/000181748.

Abstract

The concentrations of fibrin degradation products (FDP) in the urine were determined by the passive hemagglutination test in 115 patients with biopsy-proven chronic proliferating glomerulonephritis (GN), 93 patients with urinary tract infection (UTI) and 23 patients who received kidney transplants. The active GN values (12.3 micrograms/ml) are significantly higher than those for latent GN (0.3 micrograms/ml). Those for acute UTI (9.2 micrograms/ml) are significantly higher than for chronic UTI (1.3 micrograms/ml). In contrast to the reports published by others, the numerous 'false-positive' and 'false-negative' values make diagnosis of the activity questionable. Prognostic value can be expected in GN with the nephrotic syndrome (NS): patients with steroid-sensitive NS excrete FDP and patients with steroid-resistant NS excrete larger quantities of FDP. We have confirmed that a rise in the urinary FDP level in transplantation is indicative of rejection. However, since 10 of 27 rejections were FDP-negative, the absence of FDP in the urine does not preclude rejection.

摘要

采用被动血凝试验测定了115例经活检证实为慢性增殖性肾小球肾炎(GN)患者、93例尿路感染(UTI)患者和23例接受肾移植患者尿液中纤维蛋白降解产物(FDP)的浓度。活动性GN患者的值(12.3微克/毫升)显著高于潜伏性GN患者(0.3微克/毫升)。急性UTI患者的值(9.2微克/毫升)显著高于慢性UTI患者(1.3微克/毫升)。与其他人发表的报告相反,大量的“假阳性”和“假阴性”值使得对活动性的诊断存在疑问。在肾病综合征(NS)的GN中可预期其具有预后价值:对类固醇敏感的NS患者排泄FDP,而对类固醇耐药的NS患者排泄更多量的FDP。我们已经证实,移植时尿FDP水平升高表明发生了排斥反应。然而,由于27例排斥反应中有10例FDP为阴性,尿液中不存在FDP并不排除排斥反应。

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