摘要
目的探讨肾病综合征(NS)并发肺血栓栓塞(PTE)的相关危险因素及预测指标,以尽早识别出高危患者。方法采用病例对照研究,回顾性分析北京大学深圳医院2001年1月～2011年10月确诊为肾病综合征并发肺血栓栓塞的7例住院患者的临床资料,以同期确诊为肾病综合征(膜性肾病)但未发生肺血栓栓塞的患者14例为对照组。对两组数据进行比较,先行单因素分析,再选取有统计学意义的指标进行多因素Lo-gistic回归分析。结果①病例组纤维蛋白(5.28±1.61)g/L,高于对照组的(3.78±1.12)g/L(P<0.05);病例组D-二聚体定量(433.29±213.61)ng/mL,高于对照组(160.14±95.62)ng/mL(P<0.05)。病例组使用糖皮质激素者4例(57.1%),高于对照组的1例(7.1%)(P<0.05)。而年龄、病程、红细胞比积、血小板计数、血白蛋白、肌酐、尿素氮、24 h尿蛋白定量、浆膜腔积液和使用利尿剂的情况,两组之间差异无统计学意义(P>0.05);②多因素Logistic回归分析显示两组D-二聚体定量的差异有统计学意义(P<0.05),回归系数为0.016,OR值为1.016,而两组纤维蛋白原和使用糖皮质激素者的差异无统计学意义(P>0.05)。结论 D-二聚体定量对肾病综合征患者并发PTE具有一定的预测价值,血中D-二聚体水平增高应高度警惕PTE风险。
Abstract： [Objectives] To investigate the correlated risk factors and predictors of pulmonary thromboem-bolism （PTE） in nephrotic syndrome （NS） in order to identify the high risk patients and make early diagnosis. [Methods] A retrospective case-control study was performed to compare the clinical datum of 7 cases diag-nosed as nephrotic syndrome complicated with pulmonary thromboembolism with other 14 patients diagnosed as nephritic syndrome without pulmonary thromboembolism in the hospitalized database from January 2001 to Oc-tober 2011. Single factor analysis was first applied to analyze the compact degree with pulmonary thromboem-bolism. Then pick up the statistic significant indexes to apply Logistic regression analysis. [Results] In the study, the case group had statistic differences in the fibrinogen, D-dimer and glucocotieoid therapy with the control group （P〈0.05）. Other factors, such as age, disease course, hematocrit, platelet count, serum albumin, creatinine,urea nitrogen, 24 hour urine protein, serous effusion and diuretics therapy showed no statistic dif-ferences between the two groups （P 〉0.05）. Multiple factors Logistic regression analysis showed D-dimer had the statistic differences and regression coefficients was 0.016, OR was 1.016. Fibrinogen and glucocoticoid therapy showed no significant difference （P〉0.05）. [Conclusions] Pulmonary thromboembolism is usually a medical emergency. D-dimer has some value in predicting of pulmonary thromboembolism in nephrotic syn- drome. The onset of PTE must be paid attention to on a high level of D-dimer.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2013年第2期86-91,共6页
China Journal of Modern Medicine
