狼疮样抗凝物质对慢性肾脏疾病患者凝血功能的影响  

Effects of lupus anticoagulant on blood coagulation in patients with chronic kidney disease

作　　者：金艳慧[1] 王明山[1] 杨丽红[1] 虞丹丹[1] 张卓[1] 谢耀盛[1] 

机构地区：[1]温州医学院附属第一医院实验诊断中心,浙江温州325000

出　　处：《中国卫生检验杂志》2009年第11期2618-2619,2701,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的:探讨狼疮样抗凝物质(LA)与慢性肾脏疾病患者凝血功能变化的关系。方法:采用血浆蝰蛇毒时间测定170例慢性肾脏疾病患者LA比值,其中肾病综合征患者29例(NS组)、慢性肾小球肾炎患者38例(CGN组)、慢性肾功能不全代偿期患者40例(CRC组)、慢性肾功能不全失代偿期患者31例(CRD组)、慢性肾功能衰竭期患者32例(CRF组),同时采用免疫比浊法测定血浆D二聚体(D-D)及凝固法测定纤维蛋白原(FIB)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)。并与30例健康对照者(对照组)及各组间进行比较分析。结果:CRC组LA比值(1.05±0.06)、D-D(0.96±0.29)、FIB(3.36±0.92),CRD组LA比值(1.12±0.08)、D-D(1.51±0.62)、FIB(4.01±1.03),CRF组LA比值(1.18±0.09)、D-D(2.63±1.20)、FIB(4.75±1.74),差异有统计学意义(Р均<0.05),以CRF组的上述各参数变化最为显著;CGN组LA比值(1.07±0.06)、D-D(1.21±0.55)、FIB(3.32±0.85)、PT(13.2±0.8),NS组LA比值(1.13±0.09)、D-D(2.53±1.10)、FIB(5.19±1.93)、PT(12.5±0.5),差异有统计学意义(Р均<0.05);慢性肾脏疾病各组的LA比值、D-D和FIB含量与对照组LA比值(1.00±0.05)、D-D(0.39±0.10)、FIB(2.95±0.59)比较,差别有统计学意义(Р均<0.05)。结论:慢性肾脏疾病患者体内凝血功能的紊乱表现随着病情的加重越明显,且LA比值的增加与高凝状态及病变严重性相平行,LA可能是引起慢性肾脏疾病患者体内血液凝固性增高的原因之一。Objective：To investigate the relation between lupus anticoagulant（LA） and change of blood coagulation in patients with chronic kidney disease（CKD）.Methods：170 CKD patients including 29 patients with nephrotic syndrome（NS group）,38 patients with chronic glomerular nephritis（CGN group）,40 patients with compensatory stage of chronic renal insufficiency（CRC group）,31 patients with decompensatory stage of chronic renal insufficiency（CRD group）,32 patients with chronic renal failure（CRF group） and 30 healthy people（control group） were selected in the study.The ratio of LA（LAR） and D-dimer（D-D） were measured by Russell′s viper venom time（RVVT） and immunoturbidimetry respectively,and fibrinogen（FIB）,prothrombin time（PT） and activated partial thromboplastin time（APTT） were measured by solidification method.The compare means of every group was analyzed with One-Way ANOVE.Results：The levels of LAR,D-D,FIB in CRC group were 1.05±0.06,0.96±0.29,3.36±0.92 respectively.The levels of LAR,D-D,FIB in CRD group were 1.12±0.08,1.51±0.62,4.01±1.03 respectively.The levels of LAR,D-D,FIB in CRF group were 1.18±0.09,2.63±1.20,4.75±1.74 respectively.The differences of these parameters among these groups had statistical significance（all of P0.05）.And the changes of above mentioned parameters in CRF group were most obvious among those three CKD groups.The levels of LAR,D-D,FIB,PT in CGN group were 1.07±0.06,1.21±0.55,3.32±0.85,13.2±0.8 respectively.The levels of LAR,D-D,FIB,PT in NS group were 1.13±0.09,2.53±1.10,5.19±1.93,12.5±0.5 respectively.The differences of these parameters between CGN group and NS group had statistical significance（both of P0.05）.Compared with the parameters such as the levels of LAR（1.00±0.05）,D-D（0.39±0.10）,FIB（2.95±0.59） in control group,the difference of the parameters in every CKD group had statistical significance（all of P0.05）.Conclusion：The more of illness state in CKD patients was serious,the more d

关 键 词：肾脏疾病 狼疮凝固抑制物 血液凝固 

分 类 号：R692[医药卫生—泌尿科学]