血浆纤溶标志物在原发性膜性肾病疾病进展中的变化  

Changes of plasma fibrinolytic markers in idiopathic membranous nephropathy disease progress

作　　者：李臻[1] 李贞 陈伟琴[1] 殷红梅[1] 胡晓波[1] LI Zhen;CHEN Weiqin;YIN Hongmei;HU Xiaobo(Department of Clinical Laboratory,Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200030,China)

机构地区：[1]上海中医药大学附属龙华医院检验科

出　　处：《检验医学》2020年第1期25-28,共4页Laboratory Medicine

基　　金：上海市卫生和计划生育委员会面上项目（201640169）;上海中医药大学附属龙华医院国家中医临床研究基地龙医学者（育苗计划LYTD-66）

摘　　要：目的分析原发性膜性肾病(IMN)患者不同慢性肾脏病(CKD)分期血浆纤溶标志物水平的差异。方法选取200例IMN患者(IMN组,其中CKD1期103例、CKD2期53例、CKD3期30例、CKD4~5期14例)和97名体检健康者(健康对照组),检测血浆纤溶酶-α2抗纤溶酶复合物(PIC)、组织型纤溶酶原激活物抑制剂-1复合物(tPAIC)、纤维蛋白原(Fib)、纤维蛋白降解产物(FDP)、D-二聚体(DD)水平。结果IMN组Fib、FDP、DD与PIC水平显著高于健康对照组(P<0.01),tPAIC水平显著低于健康对照组(P<0.01)。IMN组不同CKD分期之间Fib和tPAIC水平差异均有统计学意义(P<0.05),随CKD分期的进展,Fib水平逐渐升高,tPAIC水平逐渐下降。Fib和tPAIC水平CKD1期与CKD3期、CKD4~5期之间差异有统计学意义(P<0.05),FDP、DD和PIC水平各CKD分期之间差异无统计学意义(P>0.05)。结论IMN患者存在纤溶系统功能低下的情况,易发生血栓栓塞。Fib和tPAIC与疾病分期有关,可作为IMN疾病进展及血栓栓塞预防的监测指标。Objective To analyze the difference of plasma fibrinolytic markers in different chronic kidney disease(CKD)stages of idipothic membranous nephropathy(IMN).Methods A total of 200 IMN patients(IMN group,including 103 cases of CKD1,53 cases of CKD2,30 cases of CKD3 and 14 cases of CKD4-5)and 97 healthy subjects(healthy control group)were enrolled.The levels of plasmin-α2 antiplasmin complex(PIC),tissue plasminogen activator-inhibitor 1 complex(tPAIC),fibrinogen(Fib),fibrin degradation product(FDP)and D-dimer(DD)were determined.Results Fib,FDF,DD and PIC in IMN group were higher than those in healthy control group(P<0.01),and tPAIC level was lower.With different CKD stages,Fib and tPAIC levels had statistical significance(P<0.05).With the increasing of CKD stages,Fib levels were increased,and tPAIC levels were decreased.For Fib and tPAIC,there was statistical significance between CKD1 and CKD3,CKD4-5(P<0.05),and there was no statistical significance for FDP,DD and PIC with different CKD stages(P>0.05).Conclusions IMN patients have poor fibrinolytic system function,and it is easy to form thromboembolia.Fib and tPAIC are related to disease stage,which can be used as the indicators of IMN disease progress and thromboembolia prevention monitoring.

关 键 词：纤溶标志物 血栓栓塞 原发性膜性肾病 

分 类 号：R446.1[医药卫生—诊断学]