摘要
目的探讨过敏性紫癜（HSP）患儿疾病活动期血浆凝血因子ⅩⅢ-A亚单位（FⅫ．A）水平变化及其他凝血纤溶指标异常与HSP重要脏器受累的关系，为合理治疗HSP提供理论依据。方法收集2012年11月至2013年3月在安徽医科大学第一附属医院住院的HSP患儿117例，并按有无重要脏器受累分为3组：普通HSP组59例，消化道出血型HSP组21例，HSP肾炎（HSPN）组37例。另选体检健康的23例儿童为健康对照组。采用双抗体夹心酶联免疫吸附（ELISA）法检测117例疾病活动期HSP患儿及21例消化道出血型HSP恢复期血浆FⅩⅢ-A水平。采用全自动血液分析仪、全自动血凝分析仪检测血WBC及其他凝血纤溶指标水平。结果1．消化道出血型HSP组血浆FⅫ．A水平显著低于其他各组（P〈0．05），病情缓解后恢复正常（t=2．17，P〈0．05）。普通HSP组、HSPN组ⅩⅢ-A与健康对照组比较差异均无统计学意义（P均〉0．05）。2．普通HSP组、消化道出血型HSP组、HSPN组纤维蛋白（原）降解产物（FDP）、D-二聚体（D．dimer）、纤维蛋白原（FIB）、WBC、PLT、血小板压积（PCT）水平均明显高于健康对照组（P均〈0．05）；消化道出血型HSP组、HSPN组FDP、D—dimer水平均显著高于普通HSP组（P均〈0．05）；消化道出血型HSP组FDP、D．dimer水平高于HSPN组（P〈0．01）。3．HSPN组血浆FⅫ-A与24h尿蛋白排泄量呈负相关（P〈0．05）。结论FⅩⅢ-A水平变化与HSP消化道、肾脏受累程度密切相关，应根据临床表现类型及不同病期选择合理的抗凝治疗。
Objective To explore the correlation between changes in plasma factor ⅩⅢ-A subunit（FⅩⅢ-A） levels in children with Henoch-Sch0nlein purpura（HSP） during active stage and involvement important organs,and other coagulation fibrinolytic dysfunction, and to provide theoretical basis for effective treatment. Methods A total of 117 children hospitalized with HSP from Nov. 2012 to Mar. 2013 in the First Affihated Hospital of Anhui Medical University were divided into 3 groups ： general HSP group （59 cases）, gastrointestinal bleeding HSP group （21 cases）, and HSP ne- phritis（HSPN） group（37 cases）. Twenty-three healthy children were included as healthy control group. The plasma F -A levels of the 117 patients with HSP during active stage and 21 HSP sufferers with gastrointestinal bleeding during recovery stage were detected by using enzyme-linked immunosorbent assay. Fully automatic hematology analyzer and fully automatic blood coagulation analyzer were used to detect blood leukocytes and other coagulation fibrinolytic inde- xes. Results 1. The levels of plasma F ⅩⅢ-A in gastrointestinal bleeding HSP group were significant lower than those in other groups （P 〈 O. 05 ） , and F ⅩⅢ-A returned to normal during recovery stage （t = 2. 17, P 〈 0.05 ）. There was no significant difference in levels of F ⅩⅢ-A among gastrointestinal bleeding HSP group, HSPN group and the healthy con- trol （ P 〉 0.05 ）. 2. The levels of Fibrin （o） gen degradation products （ FDP）, D-dimer, fibrinagen, WBC, PLT and platetet hematocrit in general HSP group, gastrointestinal bleeding HSP group and HSPN group were significant higher than those of healthy control group（ all P 〈 O. 05 ）. The levels of FDP and D-dimer in gastrointestinal bleeding HSP group and HSPN group were significant higher than general HSP group（P 〈 O. O1 ）. The levels of FDP and D-dimer in gastro- intestinal bleeding HSP group were significantly higher than those of the HSPN group （ P 〈 O. 05 ）. 3. There was a sig- nificant negative correlation between F ⅩⅢ-A and 24 h urinary protein excretion in HSPN group（ P 〈 O. 05 ）. Conclu- sions The levels of plasma F ⅩⅢ-A were correlated well with the severity of gastrointestinal bleeding and renal in- volvement in children with HSP, and anticoagulant therapy should be performed according to clinical types and in the different stages.
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2013年第21期1652-1655,共4页
Chinese Journal of Applied Clinical Pediatrics
基金
安徽省科技攻关项目（07010300198）
关键词
凝血因子ⅩⅢ-A
过敏性紫癜
肾炎
儿童
Factor ⅩⅢ-A subunit
Henoch-Schonlein purpura
Nephritis
Child
