CAJ | 학술논문

目的检测过敏性紫癜(HSP)患儿血浆血栓调节蛋白(TM)、血管性假血友病因子(vWF)水平及凝血状态指标,探讨其在HSP发病机制中的作用及临床意义.方法检测HSP患儿急性期56例、缓解期50例及30例健康对照者血浆TM、vWF以及D-二聚体、PT、APTT、血小板计数水平,比较它们在HSP患儿不同时期及其在肾受损组及非肾受损组的变化.结果急性期HSP患儿TM、vWF、D-二聚体、血小板计数高于缓解期和对照组,差异有非常显著性(P=0.000),PT、APTT较缓解期和对照组差异无显著性(P＞0.05).缓解期TM、vWF仍较对照组升高,差异有显著性(P=0.013,P=0.000),D-二聚体、血小板计数、PT、APTT较对照组差异无显著性(P＞0.05).急性期肾功能受损组TM、vWF、D-二聚体高于非肾功能受损组,差异有显著性(P＜0.05,P＜0.01),PT、APTT、血小板计数较非肾功能受损组差异无显著性(P＞0.05).结论在HSP的发病机制中存在血管内皮细胞损伤及血液高凝状态,血浆TM、vWF、D-二聚体水平测定有助于了解病情活动及是否合并肾脏损害,动态监测有助于观察病情演变、判断预后及指导治疗.
목적 검측과민성자전(HSP)환인혈장혈전조절단백(TM)、혈관성가혈우병인자(vWF)수평급응혈상태지표,탐토기재HSP발병궤제중적작용급림상의의.방법 검측HSP환인급성기56례、완해기50례급30례건강대조자혈장TM、vWF이급D-이취체、PT、APTT、혈소판계수수평,비교타문재HSP환인불동시기급기재신수손조급비신수손조적변화.결과 급성기HSP환인TM、vWF、D-이취체、혈소판계수고우완해기화대조조,차이유비상현저성(P=0.000),PT、APTT교완해기화대조조차이무현저성(P＞0.05).완해기TM、vWF잉교대조조승고,차이유현저성(P=0.013,P=0.000),D-이취체、혈소판계수、PT、APTT교대조조차이무현저성(P＞0.05).급성기신공능수손조TM、vWF、D-이취체고우비신공능수손조,차이유현저성(P＜0.05,P＜0.01),PT、APTT、혈소판계수교비신공능수손조차이무현저성(P＞0.05).결론 재HSP적발병궤제중존재혈관내피세포손상급혈액고응상태,혈장TM、vWF、D-이취체수평측정유조우료해병정활동급시부합병신장손해,동태감측유조우관찰병정연변、판단예후급지도치료.
Objective To investigate the changes and the role of plasma thrombomodulin(TM),von willebrand factor (vWF) ,and coagulation status indicators in children with Henoch-Schonlein purpura(HSP).Methods The plasma concentrations of TM,vWF were measured by ELISA method and the levels of D-dimer,PT,APTT,palatelet count were measured in 56 acute SHP patients,50 recovery patients and 40 healthy controls. Results The plasma levels of TM、vWF、D-dimer、palatelet count in acute group were significantly higher than those in healthy controls group and those of recovery group ( P = 0. 000). The plasma levels of PT、APTT showed no significant difference among three groups( P ＞ 0. 05 ). The plasma levels of TM、vWF in recovery group were significantly higher than those in healthy controls group ( P ＜ 0. 05, P ＜ 0. 01 ), while the levels of D-dimer、palatelet count reduced to nomal levels(P ＞0. 05). As compared to non-renal damage group, The plasma levels of TM、vWF、 D-dimer were higher in renal damage group ( P ＜ 0. 05, P ＜ 0. 01 ), the levels of PT 、APTT、palatelet count showed no significant difference ( P ＞ 0. 05 ). Conclusion The damage of vascular endothelium and hypercoagulability play an important role in the pathogenesis of HSP. Changes of plasma TM、 vWF、palatelet count can be used as an indicator of the early lesion of renal function.