摘要
目的:比较分析不同病理类型肾病综合征患者凝血指标的差异及相关影响因素。方法:比较微小病变(minimal change disease,MCD,n=30)、局灶节段性肾小球硬化(focal segmental glomerulosclerosis,FSGS,n=22)及膜性肾病(membranous nephropathy,MN,n=24)3组成人肾病综合征患者肾活检术前内皮素1(ET-1)、血管性血友病因子(von Willebrand Factor,v WF)及相关凝血、生化指标。选取20例健康成人作为正常对照组。采用酶联免疫吸附试验(ELISA)测定ET-1、v WF。对数据资料进行统计分析。结果:不同病理类型肾病综合征患者血浆内皮素1(ET-1)、血管性血友病因子均高于正常(P均<0.05),其中MN组血浆内皮素1(ET-1)水平明显高于FSGS组和MCD组(P<0.05);MN组血管性血友病因子水平明显高于FSGS组和MCD组(P<0.05)。FSGS与MCD患者血浆ET-1浓度分别为(147.56±42.36)pg·m L^(-1)、(138.56±38.02)pg·m L^(-1),均低于MN患者(192.1±49.16)pg·m L^(-1)(P<0.05)。FSGS与MCD患者血浆v WF含量分别为(118.30±28.12)%、(124.38±34.22)%,均低于MN患者(146.64±31.46)%(P<0.05)。Pearson相关分析显示不同病理类型肾病综合征患者其血浆内皮素1水平和v WF(r=0.525,P<0.05)、C反应蛋白(r=0.465,P<0.05)、24小时尿蛋白定量(r=0.426,P<0.05)成正相关。和肌酐、胆固醇(CHOL)、甘油三酯(TG)、抗凝血酶Ⅲ无相关性。随访中1例ET-1浓度升高MN患者发生静脉血栓。结论:肾病综合征患者血浆ET-1、v WF浓度与病理类型有关。FSGS、MCD、MN凝血指标存在差异,可能与免疫反应、内皮细胞损伤及凝血因子从尿液丢失有关。
Objective： To compare plasma coagulation indicators and relevant factors in adult nephrotic syndrome patients with different histological patterns. Methods： Endothelin-1（ ET-1）,von Willebrand factor（ vWF） and related coagulation and biochemical index of minimal change disease（ MCD,n = 30）,focal segmental glomerulosclerosis（ FSGS,n =22） and membranous nephropathy（ MN,n = 24） were compared. Twenty healthy adults served as normal controls. The blood and urinary samples were collected before renal biopsy. ET-1,vWF were detected by enzyme-linked immunosorbent assay（ ELISA）. SPSS16. 0 for windows statistical software was used to analyze the data. Results： The plasma endothelin1（ ET-1） and von Willebrand factor were significantly higher in patients with different pathological types of nephrotic syndrome（ P〈0. 05）,and plasma endothelin（ ET-1） level in group MN was significantly higher than that in group FSGS and group MCD（ P〈0. 05）; The level of von Willebrand factor（ vWF） in MN group was significantly higher than that in group FSGS and MCD group（ P〈0. 05）. Plasma ET-1 concentrations in patients with FSGS and MCD were（ 147. 56 ±42. 36） pg·mL^-1and（ 138. 56 ± 38. 02） pg·mL^-1,lower than in patients with MN（ 192. 1 ± 49. 16） pg·mL^-1（ P〈0. 05）. Plasma vWF concentrations in Patients with FSGS and MCD were（ 116. 30 ± 28. 12） % and（ 125. 38 ±34. 22） %（ P〈0. 05）,lower than in patients with MN（ 146. 64 ± 31. 46） %（ P〈0. 05）. Pearson correlation analysis showed that the plasma ET-1 level in patients with different pathological types of nephrotic syndrome was correlated positively with vWF（ r = 0. 525,P〈0. 05）,C-reactive protein（ r = 0. 465,P〈0. 05）,and 24-hour urinary protein excretion（ r = 0. 426,P〈0. 05）,and had no correlation with creatinine,cholesterol（ CHOL）,triglyceride（ TG）,and antithrombin Ⅲ. One MN patient with higher ET-1 concentration had venous thrombosis attack. Conclusion： The
出处
《赣南医学院学报》
2016年第6期880-883,共4页
JOURNAL OF GANNAN MEDICAL UNIVERSITY
基金
江西省卫生计划生育委员会课题(编号:20165350)
