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目的研究过敏性紫癜(HSP)患儿止血分子标记物D-二聚体(D-D)的变化,探讨其在HSP发病中的作用机制及临床意义。方法将40例HSP患儿根据临床有无肾脏损害分为肾炎组和非肾炎组,并以20例正常儿童作对照组。采用ELISA双抗体夹心法测定血浆D-二聚体的含量。结果两组患儿在发病初期,血浆D-D水平均明显升高,与正常对照组比较差异有统计学意义(P<0.01),且这种变化在肾炎组更为明显。恢复期,两组患儿血浆D-D水平均显著下降,较发病初期差异有统计学意义(P<0.01)。结论HSP患儿存在高凝状态,具有肾炎表现者则更具此倾向。通过对此指标的检测,可以更好的了解HSP的病理基础,有助于血栓前状态的诊断及判断预后,并为临床采取抗凝治疗提供理论依据。
Objective To study the changes of hemostatic molecular marker D-D (D-D) in children with Henoch-Schonlein Purpura (HSP) and to explore its mechanism and clinical significance in the pathogenesis of HSP. Methods Forty cases of HSP children were divided into nephritis group and non-nephritic group according to the presence or absence of renal damage and 20 normal children as control group. The level of plasma D-dimer was measured by ELISA double antibody sandwich method. Results The plasma D-D levels of both groups were significantly increased at the early stage of onset, with significant difference compared with the normal control group (P <0.01), and this change was more obvious in the nephritis group. During convalescence, plasma D-D levels in both groups were significantly decreased compared with the initial stage (P <0.01). Conclusion There is a hypercoagulable state in children with HSP, and those with nephritis are more likely to have this tendency. Through the detection of this index, we can get a better understanding of the pathological basis of HSP, help to diagnose the state of thrombus and judge the prognosis, and provide a theoretical basis for clinical anticoagulant therapy.