肾病综合征患儿白色微血栓和血浆D-二聚体水平与肾静脉血栓形成的关系

目的　研究外周微循环白色微血栓和血浆D -二聚体水平与肾病综合征 (NS)并发肾静脉血栓形成 (RVT)之间的关系。方法　采用螺旋CT肾静脉连续薄层增强扫描 (扫描层厚 2mm) ,将 10 0例NS患儿分为Ⅰ组 (无肾静脉血栓组 ,88例 )和Ⅱ组 (合并RVT组 ,12例 )。甲皱微循环下观察白色微血栓 ;ELISA法测定血浆D -二聚体水平。并以 5 0例健康儿童作对照组。结果　Ⅱ组甲皱微循环白色微血栓阳性率明显高于Ⅰ组 (P <0 .0 0 5 )。Ⅱ组血浆D -二聚体水平明显高于Ⅰ组和对照组 (P <0 .0 1,P <0 .0 0 1) ;Ⅰ组和对照组比较无明显差异 (P >0 .0 5 )。结论　NS患儿外周微循环白色微血栓阳性和血浆D -二聚体水平升高和RVT之间关系密切。

Relationship between white microthrombus, plasma D-Dimer levels and renal vein thrombosis in children with nephrotic syndrome

Objective To study the correlation between white microthrombus,plasma D-Dimer levels and renal vein thrombosis(RVT) in children with nephrotic syndrome(NS).Method One hundred NS children were divided into two groups,the group Ⅰ(n=88) was NS patients without RVT and the group Ⅱ(n=12) was NS children complicated with RVT.The RVT was diagnosed by thin layer scanning under spiral CT.White microthrombus were observated by examination of mail fold microcirculation and plasma D-Dimer levels were examined by ELISA in groups.Fifty normal children were as normal control group.Results Positive rate of white microthrombus in group Ⅱwas much higher than that in group Ⅰ(91.6% vs 20.4%, P<0.005). The plasma D-Dimer levels were significantly higher in groupⅡ(2.06±0.57?mg·L -1 ) than that of group Ⅰ(0.33±0.09?mg·L -1 )(P<0.01) and control group(0.28±0.06?mg·L -1 )(P<0.001),and that of group Ⅰhad no difference compared with that of control group(P>0.05).Conclusions The positive white microthrombus and plasma D-Dimer levels increase are closely correlated with RVT.