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目的探讨慢性肾脏病(CKD)患者血浆D-二聚体(D-D)、纤维蛋白单体(FM)及纤维蛋白原(FIB)含量与肾脏损害程度的关系。方法收集74例CKD患者血液标本,根据肾小球滤过率(GRF)分成3组,早期组(CKD 1期和2期)(GRF≥60 ml/min)20例;中期组(CKD3期)(GFR为30 ml/min~59 ml/min)27例;晚期组(CKD4期和5期)(GFR<30 ml/min)27例,和52例正常对照组血液标本,采用Clouse法检测FIB、免疫比浊法检测D-D和FM含量,分析检测指标与肾小球滤过率(GFR)的相关性。结果 CKD各期血浆FIB和D-D水平与正常对照组相比较均明显升高,CKD中期和晚期组血浆FM比正常对照组明显升高,差异均有统计学意义(P<0.05);CKD早期组和正常对照组的FM差异无统计学意义(P>0.05);CKD各期之间血浆FIB差异均无统计学意义(P>0.05);CKD晚期组比早期组和中期组的血浆D-D和FM均明显升高,差异有统计学意义(P<0.05)。CKD组患者GFR与D-D、FM呈负相关性(r值分别为-0.497、-0.645,P<0.05)。结论慢性肾脏病患者体内存在着不同程度的高凝状态,D-D和FM含量与肾脏病变的严重性相平行。
Objective To investigate the relationship between the levels of D-dimer, fibrin monomer (Fib) and fibrinogen (FIB) in patients with chronic kidney disease (CKD) and the degree of renal damage. Methods 74 patients with CKD were collected and divided into 3 groups according to glomerular filtration rate (GFR). 20 cases of early stage (CKD stage 1 and 2) (GRF≥60 ml / min) 27 cases of advanced stage (GFR <30 ml / min) and 52 cases of normal control group, Clouse method was used to detect FIB Immunoturbidimetry was used to detect the content of DD and FM, and the correlation between the detection index and glomerular filtration rate (GFR) was analyzed. Results The levels of plasma FIB and DD in all stages of CKD were significantly higher than those in normal control group. The levels of plasma FM in middle and late CKD group were significantly higher than those in normal control group (P <0.05) (P> 0.05). There was no significant difference in plasma FIB between different stages of CKD (P> 0.05). The levels of plasma DD and FM in advanced CKD group were lower than those in early and middle CKD group Were significantly higher, the difference was statistically significant (P <0.05). GFR was negatively correlated with D-D and FM in patients with CKD (r = -0.497, -0.645, P <0.05, respectively). Conclusion There are some hypercoagulable states in patients with chronic kidney disease. The D-D and FM contents are in parallel with the severity of renal disease.