维持性血液透析患者血浆 D-二聚体及纤溶系统变化研究

目的：观察维持性血液透析（M HD）患者血浆D-二聚体（D-D）水平及纤溶系统的变化，探讨血液透析对患者凝血及纤溶系统的影响。方法选择2012年5月至2013年5月江苏省连云港市东方医院血液透析中心治疗的尿毒症患者50例，分别测定透析前后D-D、纤维蛋白降解产物（FDP）、组织纤溶酶原激活物（t-PA ）及纤溶酶原激活物抑制物（PAI）水平，并与60例健康体检者（健康对照组）进行对照。结果透析前 M HD组患者血浆D-D、FDP水平及t-PA活性明显高于健康对照组，PAI明显低于健康对照组，差异有统计学意义（ P＜0．01）。透析后MHD患者血浆D-D、FDP水平及t-PA活性较透析前明显增高，PAI则明显降低，差异均有统计学意义（P＜0．05）。结论 M HD患者本身存在着纤溶系统的紊乱，而血液透析过程使得这种紊乱更加明显。

Changes of the fibrinolytic system and the level of plasma D-dimer in maintenance hemodialysis patients

Objective To observe the effect of maintenance hemodialysis（MHD） on the changes of plasma D dimer and fibrinolytic system ,to study the effect of M HD on the fibrinolytic system and the level of plasma D dimer . Methods The D dimer ,FDP ,t-PA and PAI levels were determined in 50 M HD patients before and after dialysis ,60 healthy subjects were selected into control group .Results The plasma D-dimers ,FDP and t-PA in group M HD were significantly higher than the control group before dialysis （P＆lt; 0 .01）;PAI was significantly lower than the control group .After dialysis the levels of plasma D dimers ,FDP and t-PA increased significantly ;while PAI was significantly lower than before dialysis（P＆lt;0 .01） .Conclusion The patients with MHD have coagulation and fibrinolysis system disorder ,hemodialysis makes it more obvious .