慢性肾功能衰竭患者血液透析和肾移植前后凝血-血栓形成指标的变化

目的:观察慢性肾功能衰竭(CRF)患者血液透析(血透)和肾移植前后凝血-体外血栓形成指标的变化。方法:CRF病人53例,46例采用血透治疗,7例采用同种异体肾移植。分别于治疗前、血液透析10次后、肾移植18个月后检查血浆内皮素-1(ET-1)、抗凝血酶-Ⅲ(AT-Ⅲ)水平以及体外血栓形成的长度和重量。结果:CRF患者ET-1增加,AT-Ⅲ降低,体外血栓较长、较重,与健康对照组比较P均<0.01;血透治疗后ET-1有所降低,AT-Ⅲ有所增加,但体外血栓长度和重量无显著变化(P>0.05);肾移植治疗后血浆ET-1、AT-Ⅲ以及血栓长度和重量均较治疗前有非常显著性统计学差异,P均<0.01,接近健康对照组水平。结论:ET-1和AT-Ⅲ异常变化可促进CRF患者凝血功能增强和血栓形成,肾移植能改善凝血功能,防治血栓形成。

Changes of Coagulation and Thrombosis Before and After Hemodialysis and Renal Transplantation in Patient with Chronic Renal Failure

Objective:To observe the changes of blood coagulation and vitro-thrombosis indexes before and after hemodialysis and kidney transplantation in patient with chronic renal failure(CRF).Method:53 cases CRF patients including 46 hemodialysis and 7 allogenic kidney transplantation.Before therapy,after hemodialysis 10 times or renal transplantation 18 months,all the patients,their plasma endothelin-1(ET-1)and antithrombin Ⅲ(AT-Ⅲ)level,vitro thromboplastic length and weight were examined and statistics analysis together health control group.Results:Compared with the control,the ET-1,the thrombus length and weight were obviously increased(P<0.01),but the AT-Ⅲ was clearly decreased(P<0.01)in the CRF patients;After hemodialysis 10 times,the ET-1 was slightly lowered and the AT-Ⅲ mild risen,but the length and weight were not change(P>0.05);After kidney transplantation 18 months,all above parameters were distinctively improved(P<0.01),but come back to closed to normal subjects(P>0.05).Conclusion:The coagulation function of CRF patients maybe enhanced by abnormal change of ET-1 and AT-Ⅲ,kidney transplantation can quite improve high degree blood clotting,prevent and cure thrombosis.