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目的 研究儿童过敏性紫癜 (HSP)发作期及缓解期凝血状态的改变情况及其机制。方法 2 0 0 1～2 0 0 3年深圳市儿童医院收治的HSP患儿共 6 0例 ,根据发病期和缓解期的不同 ,相应分为HSP发作组 (30例 )和HSP缓解组 (30例 ) ,检测凝血酶原时间比 (PTR)、血浆D 二聚体 (D dimer)及组织因子途径抑制物 (TFPI)水平 ,并与对照组 35例健康体检儿童比较。结果 两组HSP患儿的PTR与对照组比较差异无显著性 (均P >0 0 5 ) ;HSP发作组血浆D dimer明显升高 (P <0 0 5 ) ,而HSP缓解组血浆D dimer浓度下降 ,与对照组差异无显著性(P >0 0 5 ) ;HSP发作组血浆TFPI含量高于对照组 (P <0 0 5 ) ,HSP缓解组降至正常水平 ,和对照组比较差异无显著性 (P >0 0 5 )。结论 HSP患儿发作期凝血解溶状态处于高活动状态 ,随着病情进入缓解期高凝状态可恢复正常 ;TFPI在HSP患儿发作期可能具有防止血管内凝血活动过度和扩散的重要作用。
Objective To study the changes of coagulation status during the onset and remission of Henoch-Schonlein purpura (HSP) in children and its mechanism. Methods A total of 60 HSP children admitted to Shenzhen Children’s Hospital from 2001 to 2003 were divided into HSP group (30 cases) and HSP remission group (30 cases) according to the different stages of onset and remission (PTR), plasma D dimer and tissue factor pathway inhibitor (TFPI) were measured and compared with 35 healthy children in the control group. Results There was no significant difference in PTR between two groups (P> 0.05). The plasma D dimer in HSP group was significantly higher than that in control group (P <0.05), while the plasma D dimer level (P <0.05). The plasma level of TFPI in HSP group was significantly higher than that in control group (P <0.05), and the level in HSP alleviated group was no significant difference compared with control group Sex (P> 0.05). Conclusions The onset of coagulation and defoliation of HSP patients is highly active and may return to normal as the disease progresses into hypercoagulable state in remission. TFPI may play an important role in preventing the excessive and diffusing of intravascular coagulation during the onset of HSP.