Sagripanti A, Cupisti A, Baicchi U, Ferdeghini M, Morelli E, Barsotti G
Istituto Clinica Medica I, Università di Pisa, Italy.
Nephron. 1993;63(3):273-8. doi: 10.1159/000187209.
We measured plasma parameters of the prothrombotic state, namely thrombin-antithrombin III complex (TAT), fibrinopeptide A (FPA). D-dimer (DD), von Willebrand factor (vWF), tissue-type plasminogen activator (tPA), beta-thromboglobulin (beta TG), platelet factor 4 (PF4) and serotonin (5HT) in a series of 51 adult patients with chronic uremia: 22 were on maintenance hemodialysis (MHD) and 29 on conservative dietary treatment. Serum tumor necrosis factor alpha (TNF) was determined as well. Uremics presented significantly higher levels of TAT, FPA, DD, vWF, TNF, beta TG and 5HT than normal controls. Patients on conservative treatment showed lower levels of TAT, DD, TNF and beta TG than patients on MHD. Our results provide evidence that a prothrombotic state exists in chronic uremia and that MHD patients have a higher degree of hypercoagulation. Both hemodialysis procedure and uremia-related factors are likely to contribute to the hemostatic derangement.
我们检测了51例成年慢性尿毒症患者的促血栓形成状态的血浆参数，即凝血酶 - 抗凝血酶III复合物（TAT）、纤维蛋白肽A（FPA）、D - 二聚体（DD）、血管性血友病因子（vWF）、组织型纤溶酶原激活剂（tPA）、β - 血小板球蛋白（βTG）、血小板因子4（PF4）和5 - 羟色胺（5HT）：22例接受维持性血液透析（MHD），29例接受保守饮食治疗。同时测定了血清肿瘤坏死因子α（TNF）。尿毒症患者的TAT、FPA、DD、vWF、TNF、βTG和5HT水平显著高于正常对照组。接受保守治疗的患者的TAT、DD、TNF和βTG水平低于接受MHD的患者。我们的结果表明慢性尿毒症存在促血栓形成状态，且MHD患者的高凝程度更高。血液透析过程和与尿毒症相关的因素都可能导致止血紊乱。
