慢性肾功能衰竭腹膜透析患者的出凝血紊乱  

The disorder of bleeding and coagulation in the peritoneal dialysis patients

作　　者：陈颖[1] 徐琴君[1] 

机构地区：[1]上海市第一人民医院,200085

出　　处：《中华器官移植杂志》1997年第1期16-18,共3页Chinese Journal of Organ Transplantation

摘　　要：为了阐明慢性肾功能衰竭患者腹膜透析（PD）治疗中出血倾向和血栓形成倾向并存的矛盾状态，对26例慢性肾功能衰竭行PD治疗患者（PD组）、17例慢性肾功能衰竭保守治疗患者（CRF组）、36例慢性肾功能衰竭行血液透析治疗患者（HD组）与20例正常对照者（NC组）的凝血、抗凝血、纤维蛋白溶解（纤溶）及血小板功能进行了综合研究。结果发现：（1）PD组与正常对照组相比里高凝状态，并区PD组患者的高凝倾向比CRF组及HD组患者更严重；（2）PD组的纤港酶活性与正常对照组比较，差异不显著，但表现为继发性纤溶功能亢进，同时PD组患者纤维蛋白溶酶活性低于CRF组；（3）PD患者体内激活的血小板数目明显高于正常对照组。Plasma level of KPTT, factor Ⅷ coagulant activity, factor Ⅷ-related antigen, fibrlnogen, antithrombin Ⅲ activity, antithrombin Ⅲ antigen, tissue-plasminogen activator activity (t-PA: C), plasminogen activator inhibitor activity (PAI: C), PAI: C/t-PA: C, plasmin activity (PLm:C), D-dimer and plasma platelet α granule membrane protein were ditermined in 26 patients treated by long-term peritoneal dialysis (PD group), 17 patients with chronic renal failure undergoing conservative therapy (CRF group), 36 patients on maintenance hemodialysis (HD group)and 20 age & sex-matched normal controls (NC group). The results showed: 1. PD group had hypercoagulable state than NC group. The prothrombotic state in PD patients was most severe in contrast with CRF patients and HD patients. 2. When PD group was compared with NC group,PLm:C showed no significant differences, but they had secondary fibrinolysis following enhanced coagulation. Moreover, PLm =C in PD group was significantly depressed as compared with in CRF group. 3. the activated platelets in the PD patients were significantly elevated as compared with in the normal controls.

关 键 词：腹膜透析 肾功能衰竭 慢性 凝血酶类 

分 类 号：R692.505[医药卫生—泌尿科学]