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尿毒症患者血栓前状态的探讨 |
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trations of all these markers and the glomerular filtration rate(GFR),creatinine(Cr) in patients with uremia.Results The plasma levels of vWF, Hcy, TpP, FPA, TAT, PS and DD in patients with uremia were significantly higher than those in controls group (P<0.05 or P<0.01),and the levels of Pselectin and PC were significantly lower than those in controls group(P<0.01). Significant correlation of the concentrations of Hcy with GFR(r=-0.369,P=0.04) and Cr (r=0.274,P=0.039). And the Hcy, vWF, FPA and TpP are more sensitive and special tests of same kind tests.Conclusion The hypercoagulability may lead to the variation of hemostatic function in patients with uremia, and the damage of platelet activation may contribute to the bleeding in uremia. Hcy as well as FPA and TpP can be good foundation of clinical diagnosis.
Key words: Uremia; Prethrombotic state; Marker of hemostatic function
尿毒症患者存在着局部或全身性止血异常,这种异常多表现为高凝状态或出血倾向[1]。尿毒症的高凝状态可导致肾静脉血栓、心肌梗死等血栓栓塞并发症的发生。这种高凝状态与抗凝物质减少,血小板功能亢进,凝血因子异常及纤溶功能低下有关。而出血倾向主要是由于血小板黏附聚集功能下降或红细胞比积减少、血管壁异常,使患者出血时间延长,并易发生皮肤黏膜出血[2]。本文应用酶联免疫分析(ELISA)法检测尿毒症患者血浆血管性血友病因子(vWF)、同型半胱氨酸(Hcy)、P选择素、血栓前体蛋白(TpP)、纤维蛋白肽A(FPA)、凝血酶抗凝血酶复合物(TAT)、蛋白C(PC)、蛋白S(PS)、D二聚体(DD)的含量,旨在探讨尿毒症患者止血功能的调节及其临床意义。
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