慢性肾脏病患者血浆D-二聚体和纤维蛋白单体含量与肾脏损伤程度关系的探讨  

Exploration on the correlation of impaired renal function with D-dimer,fibrin monomer in patients with chronic kidney disease

作　　者：刘欢乐[1] 虞丹丹[1] 金艳慧[1] 杨丽红[1] 朱丽青[1] 王明山[1] LIU Huan - le YU Dan - dan JIN Yan- hui YANG Li - hong ZHU Li - qing WANG Ming - shan(Clinical Laboratory, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou , Zhejiang 325000, Chin)

机构地区：[1]温州医科大学附属第一医院检验科,浙江温州325000

出　　处：《中国卫生检验杂志》2017年第10期1464-1466,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨慢性肾脏病(CKD)患者血浆D-二聚体(D-D)、纤维蛋白单体(FM)及纤维蛋白原(FIB)含量与肾脏损害程度的关系。方法收集74例CKD患者血液标本,根据肾小球滤过率(GRF)分成3组,早期组(CKD 1期和2期)(GRF≥60 ml/min)20例;中期组(CKD3期)(GFR为30 ml/min^59 ml/min)27例;晚期组(CKD4期和5期)(GFR<30 ml/min)27例,和52例正常对照组血液标本,采用Clouse法检测FIB、免疫比浊法检测D-D和FM含量,分析检测指标与肾小球滤过率(GFR)的相关性。结果 CKD各期血浆FIB和D-D水平与正常对照组相比较均明显升高,CKD中期和晚期组血浆FM比正常对照组明显升高,差异均有统计学意义(P<0.05);CKD早期组和正常对照组的FM差异无统计学意义(P>0.05);CKD各期之间血浆FIB差异均无统计学意义(P>0.05);CKD晚期组比早期组和中期组的血浆D-D和FM均明显升高,差异有统计学意义(P<0.05)。CKD组患者GFR与D-D、FM呈负相关性(r值分别为-0.497、-0.645,P<0.05)。结论慢性肾脏病患者体内存在着不同程度的高凝状态,D-D和FM含量与肾脏病变的严重性相平行。Objective To investigate the correlation of impaired renal function with the levels of D - dimer （ D - D）, fibrin monomer（FM） and fibrinogen （FIB） in patients with chronic kidney disease （CKD）. Methods 74 cases of CKD patients＇ blood were collected and divided into three groups [ the early group with 20 cases （ CKD in stage 1 and stage 2 ） （ GRF ≥ 60 ml/min）, metaphase group with 27 cases（ CKD in stage 3 ） （GFR 30 ml/min -59 ml/min） , and late groupwith 27 cases （CKD in stage 4 and stage 5 ）（ GFR 〈 30 ml/min）] according to glomerular filtration ration（GRF）, and 52 cases of normal control were collected as the control group. FIB was measured by Clouse method, D - D and FM were both measured by immuno- turbidimetric assay. The correlation between test parameters and glomerular filtration ration （GFR） was analyzed. Results FIB and D - D levels in three groups of CKD were evidently higher than those in the control group, FM levels of the CKD metaphase group and the CKD late group were evidently higher than of the control group, with the differences statistically significant（ P 〈0.05） ; but there was no statistical significance on the difference of FM between the early group and the control group（ P 〉 0.05 ）. There was no statistical significance in the differences of FIB in CKD groups（ P 〉 0. 05 ）. D - D and FM lev- els were obviously higher in late group than those in early group and metaphase group, with the differences statistically signifi- cant（ P 〈 0.05 ）. The negative correlation between GFR and D -D, FM was found in CKD patients, and the correlation coeffi- cients were -0. 497 and -0. 645 respectively（P 〈 0.05 ）. Conclusion There are different degrees of high coagulation state in CKD patients, and the levels of D - D and FM is parallel to the severity of impaired renal function.

关 键 词：慢性肾脏病 D-二聚体 纤维蛋白单体 

分 类 号：R692.5[医药卫生—泌尿科学]