摘要
目的：观察血透患者纤溶状态的变化，探讨与临床止凝血的关系。方法：测定２０例血透（ＨＤ）患者透析过程中Ｄ－二聚体和ｔ－ＰＡ、ＰＬＧ、ＰＡＩ的动态变化，并与２８例健康者对照。结果：ＨＤ组透析前Ｄ－二聚体、ｔ－ＰＡ显著高于对照组，ＰＬＧ和ＰＡＩ明显低于对照组（Ｐ＜０．０５或Ｐ＜０．０１）。在透析过程中Ｄ－二聚体、ｔ－ＰＡ显著升高（Ｐ＜０．０１），ＰＡＩ逐渐降低（Ｐ＜０．０５），而ＰＬＧ无明显变化。结论：血透患者存在高凝状态并继发高纤溶，透析过程使这种变化更加明显。
OBJECTIVE Uremic patients on hemodialysis have a complicated disturbance of hemostasis during and after hemodialysis. D dimer(DD) as an end product of fibrinolysis has been studied as an sensitive marker of hyperfibrinolysis. In this study, we measured DD and others parameters of fibrinolysis as to investigate the homeostatic state of hemodialysis patients. METODOLOGY Twenty patients on maintenance hemodialysis and 28 healthy volunteers were involved in this study. DD was detected by ELISA, tissue type plasminogen activator(t PA), plasminogen activity(PLG) and plasminogen activator inhibitor antigen 1(PAI) were measured by flurometrical assay. RESULTS Predialysis values of DD were significantly higher in HD patients than normal control(1 13±0 57 mg/L vs 0 35±0 15 mg/L, P <0 01). DD exhibited a continuously increase during hemodialysis, with significant difference between the initial DD value at the start of hemodialysis and that at 180 after hemodialysis(1 13±0 57 gm/L,1 61±0 82 mg/L, P <0 01). During HD, tPA significantly increased at 180 minutes after the start of HD(before HD:0 41±0 23 IU/ml vs 180 min: 0 57±0 30 IU/ml, P <0 01). Whereas PAI and PLG before hemodialysis significantly lower in HD patients than normal, and both have a significant decrease at 180 minutes after the start of hemodialysis(before HD: 0 84±0 09 IU/ml vs 180 min:0 80±0 11 IU/ML, P <0 05). No significant changes of PLG was found during HD. CONCLUSION Hemodialysis patients have a hypercoagulative and secondary hyperfibrinolysis state which is significantly enhanced during hemodialysis process.
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
1997年第4期347-348,共2页
Chinese Journal of Nephrology,Dialysis & Transplantation
