肾脏淀粉样变致原发性纤维蛋白溶解亢进临床分析  

The Clinical Analysis of Primary Fibrinolysis Hyperfunction Caused by Renal Amyloidosis

作　　者：袁东[1] 滕舰[1] 孙芳[1] 

机构地区：[1]山东省烟台市烟台山医院,烟台264001

出　　处：《透析与人工器官》2008年第2期22-24,共3页Chinese Journal of Dialysis and Artificial Organs

摘　　要：目的淀粉样变性病史一种全身疾病,累及肾脏可以表现为肾病综合征。肾淀粉样变患者临床多为高凝倾向,但少数表现为出血倾向。本文通过对肾淀粉样变患者实验室检查的检测,探讨了肾淀粉样变出血改变可能的机制。方法对4例经肾穿刺确诊为淀粉样变伴有出血的患者检测检测血常规,血生化、24小时尿蛋白定量、优球蛋白溶解实验(ELT)、血凝常规、3P、纤溶酶原抗原(PLG),组织型纤溶酶原激活剂抗原(t-PA:Ag),尿激酶型纤溶酶原激活剂抗原(u-PA:Ag),纤溶酶原激活物-抗原含量(PAI-1:Ag),(PAI-2:Ag),a2抗纤溶酶(a2-AP),纤维蛋白原降解产物(FDPs),D-二聚体(D-D),并进行治疗。结果4例患者确诊为原发性纤维蛋白溶解亢进症。结论肾脏淀粉样变可以引起患者纤溶功能紊乱,导致原发性纤维蛋白溶解亢进,临床表现为多种出血。需早期诊断、治疗。Objective Amyloidosis is a kind of systemic diseases, involved renal may be presented as renal syndrome. Most patients with renal amyloidosis tend to high-coagulation in clinic, but a few cases tend to bleeding. In this paper the author discusses the system of hemorrhage change through the laboratory examination to the patients with renal amyloidosis. Methods Detect blood routine, blood biochemistry, quantitative of urinary protein in 24 hours, euglobulin lysis time（ ELT）, blood coagulation routine, plasminogen antigen, tissue - type plasminogen activator （ t-PA： Ag）, urea plasminogen activator （ u-PA ： Ag）, the content of plasminogen activator （ PAI-1： Ag ）, （ PAI-2 ： Ag ）, antiplasmin（ a2-AP）, fibrinogen degradation product（ FDPs）, D-dimer （D-D） to 4 patients with amyloidosis accom-anied by hemorrhage, diagnosed by renal biopsy. Results 4 patients were diagnosed as primary fibrinolysis hyperfunction. Conclusion Renal amyloidosis may cause fibrinolysis dysfunction and lead to primary fibrinolysis hyperfunction, presented various hemorrhage in clinic, which need diagnosis and treatment in early period.

关 键 词：肾淀粉样变 纤溶亢进 

分 类 号：R692[医药卫生—泌尿科学]