儿童过敏性紫癜凝血纤溶系统变化与肾损伤的相关性分析

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摘要目的分析儿童过敏性紫癜（HSP）凝血纤溶系统变化与肾损伤的相关性。方法选取2016年6月～2018年6月我院收治的76例临床急性期紫癜患儿作为研究对象，根据肾损伤指标的不同分为HSP组（41例）和紫癜性肾炎（HSPN）组（35例），选取同期20例健康儿童作为对照组。采用血凝仪自动检测并比较三组血浆中的纤维蛋白原（FIB）、D-二聚体（D-D）、纤维蛋白降解产物（FDP）及肾损伤指标尿β2-微球蛋白（β2-MG）水平；分析HSPN组血浆中FIB、D-D、FDP 与肾损伤指标尿β2-MG的相关性。结果 HSP组和HSPN组的FIB、D-D、FDP水平高于对照组，HSPN组的FIB、D-D、FDP水平高于HSP组，差异均有统计学意义（P＜0.05）。HSP组和HSPN组的尿β2-MG水平高于对照组，HSPN组的尿β2-MG 水平高于HSP组，差异均有统计学意义（P＜0.05）。HSPN组血浆中的FIB、D-D、FDP 与肾损伤指标尿β2-MG 成正相关（r=0.5655，P＜0.05；r=0.5577，P＜0.05；r=0.3906，P＜0.05）。结论 HSPN 患儿血浆中的FIB、D-D、FDP水平升高，且与肾损伤指标尿β2-MG 成正相关，HSPN 患儿在疾病早期存在凝血及纤溶系统的异常，可能参与了肾损害发生发展的过程。

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	江雄
	冯战桂
	袁科龙

关键词 ：过敏性紫癜, 紫癜性肾炎, 凝血纤溶系统, 肾损害, 相关性分析

Abstract：Objective To analyze the correlation between changes of coagulation fibrinolysis system and renal injury in children with henoch-schonlein purpura (HSP).Methods A total of 76 children with clinical acute pura in our hospital from June 2016 to June 2018 were selected as the study objects,according to the different renal injury indexes,they were divided into HSP group (41 cases) and henoch-schonlein purpura nephritis (HSPN) group (35 cases),20 healthy children in the same period were selected as the control group.The fibrinogen(FIB),D-dimer (D-D),fibrin degradation product (FDP) and renal injury index urine β2-microglobulin (β2-MG) were detected and compared automatically by hemagglutination.Correlation between plasma FIB,D-D,FDP and renal injury index urine β2-MG in HSPN group was analyzed.Results The levels of FIB,D-D,and FDP in the HSP group and HSPN group were higher than those in the control group,the levels of FIB,D-D,and FDP in the HSPN group were higher than those in the HSP group,the differences were statistically significant (P＜0.05).The levels of urine β2-MG in the HSP group and HSPN group were higher than those in the control group,and the level of urine β2-MG in the HSPN group was higher than that in the HSP group,the differences were statistically significant (P＜0.05).There was a positive correlation between FIB,D-D,and FDP in the plasma of the HSPN group and the renal damage index urine β2-MG (r=0.5655,P＜0.05；r=0.5577,P＜0.05；r=0.3906,P＜0.05).Conclusion The plasma levels of FIB,DD,and FDP in children with HSPN are elevated,and they are positively correlated with the renal damage indicator urine β2-MG.Children with HSPN have abnormalities in the coagulation and fibrinolytic system in the early stages of the disease,which may be involved in the development of renal damage.process.

Key words： Henoch-schonleinpurpura Henoch-schonlein purpura nephritis Coagulation fibrinolysis system Renal injury Correlation analysis

基金资助:广东省深圳市坪山新区卫生系统科研项目（201606）

作者简介: 江雄（1979-），男，本科，副主任医师，研究方向：儿童过敏紫癜发病机制研究

引用本文:

江雄；冯战桂；袁科龙. 儿童过敏性紫癜凝血纤溶系统变化与肾损伤的相关性分析[J]. 中国当代医药, 2020, 27(5): 127-130.
JIANG Xiong ；FENG Zhan-gui ；YUAN Ke-long. Correlation analysis between changes of coagulation fibrinolysis system and renal injury in children with henoch-schonlein purpura. 中国当代医药, 2020, 27(5): 127-130.

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