纤维蛋白单体聚合功能与血栓前状态标志物在尿毒症透析前后的变化  

The variation of fibrinogen kinrtics and the markets of prothrombotic state in before and after hemodialysis therapy

作　　者：刘燕婕[1] 王曦[1] 付玲[2] 

机构地区：[1]华中科技大学同济医学院附属协和医院检验科,武汉430022 [2]华中科技大学同济医学院附属协和医院肾内科,武汉430022

出　　处：《临床泌尿外科杂志》2006年第8期621-622,624,共3页Journal of Clinical Urology

摘　　要：目的:观察纤维蛋白单体聚合功能(FMPF)、组织型纤溶酶原激活物(tPA)及外周血浆因子Ⅷ相关抗原(vWFAg)在血液透析(HD)前后的改变及意义。方法:采用纤维蛋白单体聚合动力学检测法及酶联免疫吸附法(ELISA法)测定健康人及尿毒症患者HD前后的FMPF、tPA和vWFAg的含量。结果:HD前后,肾病患者FMPV、Fbg、tPA及vWFAg的差异有统计学意义;HD前,FMPV、Fbg、vWFAg明显高于正常对照组(P<0.05),tPA明显低于正常对照组(P<0.05);HD后1h,FMPV、Fbg、vWFAg较HD前显著升高(P<0.05),tPA明显高于正常对照组(P<0.05);HD后24h,FMPV、Fbg、vWFAg的变化较HD前更为显著升高(P<0.01),tPA恢复至透析前水平。结论:肾功能衰竭患者的Fbg、vWFAg较正常人明显增高,经HD后进一步增高而致凝血机制过度激活,导致纤维蛋白沉积增多,加之HD后组织释放的活化剂使tPA显著降低,使肾静脉血栓的发生率提高,特别经多次HD者,更易发生肺栓塞。因此,以FMPF、vWFAg及tPA作为对肾病患者HD前后的病程进展及预后的评价指标,有一定的临床应用价值。Objective：To observe the variation of fibrinogen kinetics and the markets of prothrombotic state in before and after hemodialysis therapy. Methods：Fibrin moud polymerization velocity （FMPV）optical detetions were measured in health individuals and patients with chronic renel failure and the levels of Vonwill ebrand factor autigen（VwFAg） and tissue piasminogen activators（tPA） were measured by ELISA in them. Results： To be compared with control group patients with chronic renel failure had higher plasma levels of FMPV ,Fbg and VwFAg（ P〈 0.05）and these patients had lower plasma levels of tPA （ P 〈0.05）. After hemodialysis therapy the parememters such as FMPV,Fbg,VwFAg and IPA in these patients have significant different from those of before hemodialysis therapy. Conclusions：The determination of fibrinogen kinetics Vonwillebrand factor autigen and tPA are valunable in the surpervision of hemodialysis therapy.

关 键 词：尿毒症 血液透析 纤维蛋白单体聚合速率 组织型纤溶酶激活物 

分 类 号：R692.5[医药卫生—泌尿科学]