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目的:观察移植肾在动脉开放后其静脉血中有无高凝状态以及与血栓形成的关系。方法:19例行肾移植术病人,术前采取桡动脉血标本为对照;肾动脉开放后5分钟和输尿管吻合后5分钟各采取肾静脉血,分别测定抗凝血酶Ⅲ(AT-Ⅲ)活性、D-二聚体(D-D)含量及血小板最大聚集率。结果:桡动脉血AT-Ⅲ活性和D-D含量接近正常,肾静脉血D-D含量与术前桡动脉血值相比无显著差异,而AT-Ⅲ活性值升高有非常显著的差异(P<0.01)。桡动脉血和肾静脉血血小板最大聚集率均高于正常值(P<0.01)。结论:移植肾静脉血呈高凝状态,抗凝活性升高,但纤溶活性无显著变化,提示有潜在的血栓形成的危险性。
OBJECTIVE: To observe the presence or absence of hypercoagulability in venous blood and its relationship with thrombosis after the artery is opened. Methods: Nineteen patients undergoing renal transplantation were treated with radial artery blood samples before operation. Renal venous blood was collected at 5 minutes after renal artery opening and 5 minutes after ureteral anastomosis. Antithrombin Ⅲ (AT-Ⅲ) Activity, D-dimer (DD) content and platelet aggregation rate. Results: The AT-Ⅲ activity and DD content in radial artery were close to normal. There was no significant difference in DD content between the two groups (P <0.01) ). Radial artery and renal venous blood platelet aggregation rate were higher than the normal value (P <0.01). CONCLUSION: Venous blood in renal transplant recipients showed hypercoagulable state with increased anticoagulant activity but no significant change in fibrinolytic activity suggesting a potential risk of thrombosis.