肾功能衰竭血液透析患者血小板活化标志物及凝血标志物检测临床价值分析

目的探讨肾功能衰竭维持性血液透析患者血小板颗粒膜蛋白(CD62P)、血小板溶酶体颗粒膜蛋白(CD63)、凝血酶敏感蛋白(TSP)、抗凝血酶Ⅲ(AT-Ⅲ)、D-二聚体(D-D)及纤维蛋白原(FIB)水平变化及临床价值。方法于126例血液透析患者透析前后进行上述各指标检测,并与52例体检健康者(对照组)进行比较。结果血液透析前后患者CD62P、CD63、TSP、D-D、FIB水平均高于对照组,AT-Ⅲ水平低于对照组(P<0.05);患者透析前后所有指标检测结果比较差异无统计学意义(P>0.05)。结论肾功能衰竭患者体内血小板处于活化状态,且抗凝作用减弱,导致血液呈高凝状态,易继发血栓性疾病,且血液透析未能改善此高凝状态。

Changes and clinical significance of platelet activation markers and blood coagulation indicators in patients with renal failure receiving hemodialysis

Objective To investigate the changes and clinical significance of platelet granule membrane protein（CD62P）,lysosomal granule membrane protein（CD63）,thrombin sensitive protein（TSP）,antithrombin Ⅲ（AT-Ⅲ）,D-dimer（D-D） and fibrinogen（FIB） in patients with renal failure receiving hemodialysis.Methods Levels of indicators mentioned above were detected in 126 patients with renal failure receiving hemodialysis before and after dialysis,and compared with those in 73 healthy subjects（control group）.Results Before and after hemodialysis,levels of CD62P,CD63,TSP,D-D,FIB were higher than those in control group,but that of AT-Ⅲ were lower（P0.05）,and there was no significant difference of these indicators in patients before and after dialysis（P0.05）.Conclusion The platelet in patients with renal failure might be activated,and with weakened anticoagulation effect,causing hypercoagulable state to lead thrombosis,while hemodialysis might can not improve the presence of this hypercoagulable state.