关键词: 特发性膜性肾病, 肾病综合征, 血小板功能亢进, 血栓弹力图

Abstract:

Ｏｂｊｅｃｔｉｖｅ：To investigate the specific manifestation and influencing factors of the coagulation disorders in patients with idiopathic membranous nephropathy (IMN).
Ｍｅｔｈｏｄｏｌｏｇｙ：Two hundred forty two patients with nephrotic syndrome, who were diagnosed as IMN by renal biopsy from January 2012 to September 2016 in our clinical research center, were enrolled into this respective study. Their R time, K time, α angle, MA value, and coagulation index (CI) in thrombronelastogram (TEG) were analyzed. Besides, 81 IMN patients with 24h urinary protein less than 1g were regarded as control group.
Ｒｅｓｕｌｔｓ：Significant difference was noticed in MA value between IMN with nephrotic syndrome group and control group （696 vs 651 mm，P＜001）, but not in R time（60 vs 61 min，P=072）. With regard to IMN patients with nephrotic syndrome, correlation analysis showed that serum albumin was negatively related to MA value（r=-019，P＜001）, α angle（r=-016，P=001）and CI（r=-013，P=005）, positively related to K time（r=012，P=006）, but not related to R time（r=001，P=087）. Multiple linear regression analysis indicated that serum albumin was an independent relevant factor of platelet hyperactivity in IMN. And there were no differences in all the clinical characteristics and TEG parameters between antiPLA2R（+）and antiPLA2R（-） IMN patients with nephrotic syndrome.
Ｃｏｎｃｌｕｓｉｏｎ：Platelet hyperactivity is correlated closely to the coagulation disorders of IMN. Platelet hyperactivity is related to nephrotic syndrome state, but not PLA2R antibody. These results indicate that combination of anticoagulant and antiplatelet therapy may decrease the incidence of thromboembolic events in IMN.

Key words: idiopathic membranous nephropathy, nephrotic syndrome, platelet hyperactivity, thromboelastogram