狼疮样抗凝物质对原发性肾病综合征患者血栓前状态的影响

目的探讨狼疮样抗凝物质（LA）对原发性肾病综合征（PNS）患者血栓前状态的影响。方法采用血浆蝰蛇毒时间测定32例PNS患者（PNS组）和30名健康对照组的LA比值（LAR）,同时检测血浆D二聚体（D-D）、血管性血友病因子（vWF）、纤维蛋白原（FIB）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）及血小板计数（PLT）。结果PNS组的LAR（1.10±0.09）、D-D1.28（0.27-20.00）mg/L]、vWF（212.7±80.6）%]、FIB（5.14±2.18）g/L]、PLT（231.7±63.6）×10^9/L]、PT（12.5±0.8）s]与健康对照组的LAR（1.00±0.05）、D-D0.41（0.15-0.55）mg/L]、vWF（103.2±12.8）%]、FIB（3.06±0.59）g/L]、PLT（179.7±37.9）×10^9/L]、PT（13.6±0.6）s]比较,差异有统计学意义（P均〈0.05）;以超过健康对照组x-±s为阳性,PNS患者LAR的阳性率（78.1%）与各参数的阳性率D-D（90.6%）、vWF（93.8%）、FIB（75.0%）、PLT（62.5%）、PT（75.0%）之间差异无统计学意义（P均〉0.05）。结论PNS患者LA比值的增高与血栓前状态指标的变化相平行,PNS血栓前状态的发生或发展与LA有关;LA比值可作为PNS血栓前状态的监测指标之一。

The influence of lupus anticoagulant on prethrombotic state in patients with primary nephrotic syndrome

Objective To investigate the influence of lupus anticoagulant（LA） on prethrombotic state in patients with primary nephrotic syndrome（PNS）.Methods The LA ratios（LAR） in 32 patients with PNS（PNS group） and 30 healthy subjects（healthy control group）were measured by Russell′s viper venom time.The levels of plasma D-dimer（D-D）,von Willebrand factor（vWF）,fibrinogen（FIB）,prothrombin time（PT）,activated partial thromboplastin time（APTT） and platelet count（PLT） were determined.Results The levels of LAR,D-D,vWF,FIB,PLT and PT in PNS group were（1.10±0.09）,1.28（0.27-20.00）mg/L],（212.7±80.6）%],（5.14±2.18）g/L],（231.7±63.6）×10^9/L] and （12.5±0.8）s] respectively.The levels of LAR,D-D,vWF,FIB,PLT and PT in healthy control group were（1.00±0.05）,0.41（0.15-0.55）mg/L],（103.2±12.8）%],（3.06±0.59）g/L],（179.7±37.9）×10^9/L] and （13.6±0.6）s] respectively.There was statistical difference between the two groups（P〈0.05）.The values of LAR,D-D,vWF,FIB and PLT greater than x＋s and the value of PT lower than x-s of healthy control group were considered as positive.The positive rates of LAR,D-D,vWF,FIB,PLT and PT in PNS group were 78.1%,90.6%,93.8%,75.0%,62.5% and 75.0% respectively.The differences of the positive rates had no statistical significance between LAR and other parameters（P〉0.05）.Conclusions The increase of LAR and the change of prethrombotic state parameters in patients with PNS are at equal pace.The development of prethrombotic state in PNS is associated with LA.The LAR may be one of monitoring markers to judge prethrombotic state in patients with PNS.