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目的探讨肾病综合征(NS)合并静脉血栓的临床和病理分析。方法采用全自动生化分析仪分别检测24例正常对照组、肾病综合征无静脉血栓组和静脉血栓组的24 h尿蛋白(Up),血白蛋白(ALB),脂蛋白(a)[LP(a)],纤维蛋白原(FBG)的变化。静脉血栓组经肾活检穿刺已明确病理类型。结果静脉血栓组病理中膜性肾病约占37.5%,其次为膜增殖性肾炎,约占25.0%。无静脉血栓组和静脉血栓组Up、ALB、LP(a)、FBG与正常对照组比较差异有统计学意义(P<0.01),静脉血栓组Up、ALB、FBG与无静脉血栓组比较差异有统计学意义(P<0.05),但LP(a)、差异无统计学意义(P>0.05)。结论静脉血栓组病理中膜性肾病为最多,其次为膜增殖性肾炎。ALB、LP(a)在NS合并静脉血栓形成过程中起着重要作用,LP(a)与病理类型无关,故对NS患者进行治疗时,不仅要强调结合病理类型进行抗凝治疗,而且不能忽视降脂治疗,尤其是LP(a)的治疗。
Objective To investigate the clinical and pathological features of nephrotic syndrome (NS) complicated with venous thrombosis. Methods 24 cases of normal control group, 24 cases of nephrotic syndrome without venous thrombosis group and 24 cases of venous thrombosis group were examined with automatic biochemistry analyzer. The serum levels of albumin (ALB), albumin (ALB), lipoprotein (a) [LP a)], fibrinogen (FBG) changes. Venous thrombectomy group by renal biopsy has clear pathological type. Results The pathologic nephropathy of the venous thrombus group accounted for 37.5%, followed by the proliferative nephritis, accounting for 25.0%. There were significant differences in UP, ALB, LP (a) and FBG between venous thrombosis group and venous thrombosis group and normal control group (P <0.01). There was significant difference between UP, ALB, FBG and no venous thrombosis group Statistical significance (P <0.05), but LP (a), the difference was not statistically significant (P> 0.05). Conclusion Venous thrombosis group is the most pathological nephropathy, followed by membranoproliferative nephritis. ALB, LP (a) plays an important role in the process of NS complicated with venous thrombosis. LP (a) has nothing to do with the type of pathology. Therefore, we should not only emphasize the combination of pathology and anticoagulant therapy, but also ignore Lipid-lowering therapy, especially LP (a).