D-二聚体和Cys-C联合检测在肾病综合征中的临床意义

目的 探讨D-二聚体、凝血酶原时间(PT)、纤维蛋白原(FIB)和胱抑素C(Cys-C)联合检测对肾病综合征(NS)患者并发血栓栓塞的临床价值.方法 选择2013年4月至2016年3月黄石市中心医院经临床确诊的NS患者65例(观察组),其中NS无血栓并发症患者45例(A组),NS并发血栓患者20例(B组),选择该院同期健康体检者43例作为对照组(C组).采用电化学发光法检测血清Cys-C和24 h尿蛋白水平;采用散射比浊法检测PT、FIB和D-二聚体水平,观察其在NS患者并发血栓栓塞中的变化.结果 Cys-C、24 h尿蛋白和D-二聚体在观察组中明显高于对照组(P＜0.01);观察组和对照组PT、FIB水平比较差异无统计学意义(P＞0.05);观察B组中D-二聚体和Cys-C水平明显高于观察A组(P＜0.05),且D-二聚体水平与Cys-C呈正相关.结论 D-二聚体和Cys-C可作为NS患者发生血栓栓塞的预测因子.

Clinical significance of combined detection of D-dimer and Cys-C in nephrotic syndrome

Objective To study the clinical value of combined detection of D-dimer,PT,FIB and Cyc-C in the patients with nephrotic syndrome(NS) complicating thromboembolism.Methods Sixty-five patients with clinically diagnosed NS(observation group) in the Huangshi Municipal Central Hospital from April 2013 to March 2016 were selected and divided into the non-thromboembolism group(group A,45 cases) and thromboembolism group(group B,20 cases).Contemporaneous 43 individuals undergoing physical examination served as the control group(group C).The levels of Cys-C and 24 h urine protein were tested by the electrochemical luminescence method;meanwhile PT,FIB and D-dimmer levels were detected by the nephelometry method.Their changes in the patients with NS complicating thromboembolism were observed.Results The levels of Cys-C,24 h urine protein and D-dimer in the observation group were significantly higher than those in the control group (P＜0.01).The difference of PT and FIB levels were not statistically significant(P＞0.05);the D-dimer and Cys-C levels in the observation B group was significantly higher than that in the observation A group(P＜0.05),moreover the D-dimer level was positively correlated with Cys-C.Conclusion D-dimer and Cys-C can be used as the predictive factors of thromboembolism occurrence in NS patients.