血清免疫球蛋白结合凝血四项、血小板指标诊断肾病综合征的临床价值研究  

Clinical value of four items of serum immunoglobulin combined with coagulationand platelet count in the diagnosis of nephrotic syndrome

作　　者：贾晓冰 周炳烨 JIA Xiaobing;ZHOU Bingye(Department of Clinical Laboratory,Zhengzhou Hospital of Traditional Chinese Medicine,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州市中医院检验科,河南郑州450000

出　　处：《现代医药卫生》2025年第3期649-652,656,共5页Journal of Modern Medicine & Health

摘　　要：目的 探讨血清免疫球蛋白(Ig)结合凝血四项[凝血酶原时间、活化部分凝血活酶时间、凝血时间(TT)、纤维蛋白原]、血小板指标[血小板计数、血小板比容、血小板平均容积、血小板分布宽度(PDW)]诊断肾病综合征的临床价值。方法 选取2020年4月至2021年4月该院收治的肾病综合征患者50例作为病例组,并根据病情严重程度分为肾功能代偿期组(30例)和肾功能失代偿期组(20例),另选取同期健康人群作为对照组(50例)。检测各组研究对象血清Ig、凝血四项、血小板指标等,比较各组研究对象各项指标的差异,探讨血清Ig结合凝血四项、血小板指标诊断肾病综合征的临床价值。结果 病例组患者TT、PDW水平与对照组比较,差异均无统计学意义(P>0.05);其余血清Ig结合凝血四项、血小板指标与对照组比较,差异均有统计学意义(P<0.001)。肾功能代偿期组患者IgG、IgA、凝血酶原时间、活化部分凝血活酶时间、TT、血小板计数、血小板比容、血小板平均容积、PDW水平均明显高于肾功能失代偿期组,IgM、纤维蛋白原水平均明显低于肾功能失代偿期组,差异均有统计学意义(P<0.01)。结论 肾病综合征患者存在不同程度机体免疫功能紊乱及血液高凝现象,血清Ig结合凝血四项、血小板指标检测能提高对肾病综合征患者的诊断价值,且可评估病情严重程度。Objective To investigate the clinical value of serum immunoglobulin(Ig)combined with coagulation[prothrombin time,activated partial thromboplastin time,thrombin time(TT),fibrinogen]and platelet indexes[platelet count,platelet specific volume,mean platelet volume,and platelet distribution width(PDW)]in the diagnosis of nephrotic syndrome.Methods A total of 50 patients with nephrotic syndrome admitted to our hospital from April 2020 to April 2021 were selected as the case group,and were divided into renal function compensation group(30 cases)and renal function decompensation group(20 cases)according to the severity of the disease,and healthy people in the same period were selected as the control group(50 cases).Serum Ig,4 coagulation items and platelet count were detected in each group,and the differences in various indexes were compared among the groups,so as to explore the clinical value of serum Ig combined with 4 coagulation items and platelet count in the diagnosis of nephrotic syndrome.Results There was no significant difference in TT and PDW levels between case group and control group(P>0.05).The other serum Ig combined with coagulation and platelet indexes were significantly different from the control group(P<0.001).IgG,IgA,prothrombin time,activated partial thromboplastin time,TT,platelet count,platelet specific volume,average platelet volume and PDW level in renal function compensation stage group were significantly higher than those in renal function decompensated stage group,while the average IgM and fibrinogen water were significantly lower than those in renal function decompensated stage group,with statistical significance(P<0.01).Conclusion All patients with nephrotic syndrome have different degrees of immune dysfunction and blood hypercoagulability.Serum immunoglobulin combined with four coagulation and platelet indexs count can improve the diagnostic value of patients with nephrotic syndrome,and can evaluate the severity of the disease.

关 键 词：肾病综合征 免疫球蛋白类 凝血四项 血小板指标 诊断 

分 类 号：R692[医药卫生—泌尿科学] R446[医药卫生—外科学]