CAJ | 학술논문

目的：探讨慢性肾功能衰竭患者血浆黏度、纤维蛋白原与D-二聚体的变化及其临床意义。方法：收集2006-2012年广州医科大学第一附属医院收治的72例CRF患者作为观察组，根据内生肌酐清除率( Ccr)的不同分为甲组(10 ml/min≤Ccr<50 ml/min，42例)和乙组( Ccr<10 ml/min，30例)。另选取同期30例健康体检者作为正常对照组。比较3组血浆黏度、纤维蛋白原、血浆D-二聚体的变化及与CRF的关系。结果：观察组中甲组和乙组患者的血浆黏度、血浆纤维蛋白原和血D-二聚体水平较对照组明显增高( P<0.05)。随着患者肾功能损害程度的加重及Ccr的下降，这三项指标的水平逐渐升高，CRF患者血浆黏度与D-二聚体的升高呈显著正相关(r＝0.68，P<0.05)。结论：随着患者肾功能损害程度的加重，血浆黏度、纤维蛋白原与D-二聚体的水平逐渐升高，纠正凝血纤溶平衡紊乱对CRF的治疗和其并发症的防治具有重要意义。
목적：탐토만성신공능쇠갈환자혈장점도、섬유단백원여D-이취체적변화급기림상의의。방법：수집2006-2012년엄주의과대학제일부속의원수치적72례CRF환자작위관찰조，근거내생기항청제솔( Ccr)적불동분위갑조(10 ml/min≤Ccr<50 ml/min，42례)화을조( Ccr<10 ml/min，30례)。령선취동기30례건강체검자작위정상대조조。비교3조혈장점도、섬유단백원、혈장D-이취체적변화급여CRF적관계。결과：관찰조중갑조화을조환자적혈장점도、혈장섬유단백원화혈D-이취체수평교대조조명현증고( P<0.05)。수착환자신공능손해정도적가중급Ccr적하강，저삼항지표적수평축점승고，CRF환자혈장점도여D-이취체적승고정현저정상관(r＝0.68，P<0.05)。결론：수착환자신공능손해정도적가중，혈장점도、섬유단백원여D-이취체적수평축점승고，규정응혈섬용평형문란대CRF적치료화기병발증적방치구유중요의의。
Objective:To investigate the significance of the changes in plasma viscosity, fibrinogen and D-dimer in patients with chronic renal failure (CRF). Methods: Between 2006 and 2012, we recruited 72 CRF patients from the First Affiliated Hospital of Guangzhou Medical University who were,based on their endogenous creatinine clearance rate ( Ccr),allocated to group A ( 10ml/min≤Ccr<50 ml/min) and group B ( Ccr<10 ml/min) . Thirty healthy adults were recruited from the Health Check-up Center of the First Affiliated Hospital of Guangzhou Medical University served as the control group. The association between changes in plasma viscosity,fibrinogen and D-dimer and CRF was analyzed. Results: The plasma viscosity, fibrinogen and D-dimer were unanimously increased in groups A and B as compared with control group (all P<0.05). The plasma viscosity,fibrinogen and D-dimer demonstrated a trend towards higher levels as with the increasing disease severity and reduction in Ccr levels. The increase in plasma viscosity was positively correlated with that in fibrinogen ( r=0. 68, P<0.05) . Conclusion:The levels of plasma viscosity,fibrinogen and D-dimer increase with worsening renal injury,suggesting the importance for correction of impaired coagulation-fibrinolysis balance in the treatment of CRF and its complications.