Krawczyk W, Dmoszyńska A, Sokołowska B
Oddziału Chorób Wewnetrznych Szpitala Wojewódzkiego w Chełmie.
Wiad Lek. 1994 Feb;47(3-4):93-9.
The greatest role in the development of haemostasis disturbances in patients with chronic renale failure (CRF) is ascribed to the platelets. The purpose of the work was study of basic parameters of platelet haemostasis in patients with CRF treated both conservatively and subjected to repeated haemodialyses. A correlation was also sought between the degree of renal failure intensity and haemostasis disturbances. The subject of the study were 18 patients treated conservatively and 21 patients subjected to repeated haemodialyses. In the patients the following was determined: platelet count, bleeding time, aggregation by Breddin and Born methods, availability of platelet factor 3 (PF3), activity of platelet factor 4 (PF4), and also the concentrations of urea, creatinine, uric acid, albumins, sodium, potassium, calcium, haemoglobin, and red blood cell count, haematocrit, and endogenous creatinine clearance. In non-dialysed patients, in relation to the control group, unchanged platelet count was shown as well as prolonged bleeding time, increased aggregation assessed by the Breddin method but unchanged by the Born method, decreased PF3 availability and unchanged PF4 activity. Aggregation and bleeding time were correlated with the degree of uraemia progression assessed on the basis of biochemical parameters, while platelet count was correlated only with urea concentration. In haemodialysed patients unchanged platelet count was demonstrated as well as prolonged bleeding time, increased aggregation assessed by the Breddin method but simultaneously decreased in the Born method, increased PF3 availability and unchanged PF4 activity. In this group of patients the correlations were only found between bleeding time and haemoglobin concentration, haematocrit, and red blood cell count.(ABSTRACT TRUNCATED AT 250 WORDS)
慢性肾衰竭(CRF)患者止血功能紊乱的发展中,血小板起了最大作用。本研究的目的是探讨接受保守治疗和反复血液透析的CRF患者血小板止血的基本参数。同时还探寻肾衰竭严重程度与止血功能紊乱之间的相关性。研究对象为18例接受保守治疗的患者和21例接受反复血液透析的患者。测定了患者的以下指标:血小板计数、出血时间、Breddin法和Born法的聚集功能、血小板因子3(PF3)活性、血小板因子4(PF4)活性,以及尿素、肌酐、尿酸、白蛋白、钠、钾、钙、血红蛋白、红细胞计数、血细胞比容和内生肌酐清除率。在未透析患者中,与对照组相比,血小板计数未变,但出血时间延长,Breddin法测定的聚集功能增强而Born法测定的未变,PF3活性降低,PF4活性未变。聚集功能和出血时间与根据生化参数评估的尿毒症进展程度相关,而血小板计数仅与尿素浓度相关。在血液透析患者中,血小板计数未变,但出血时间延长,Breddin法测定的聚集功能增强而Born法测定的同时降低,PF3活性增加,PF4活性未变。在这组患者中,仅发现出血时间与血红蛋白浓度、血细胞比容和红细胞计数之间存在相关性。(摘要截断于250字)