ABSTRACT
Objective@#To investigate the changes of coagulation and fibrinolysis system in children with Henoch-Schonlein purpura nephritis and its clinical significance.@*Methods@#From January 2013 to December 2016, 73 children with Henoch-Schonlein purpura inthe First People's Hospital of Huzhouwere selected as the Henoch-Schonlein purpura group, 73 children with Henoch-Schonlein purpura nephritis were selected as the Henoch-Schonlein purpura nephritis group, and 73 healthy children were selected as the control group.Antithrombin III activity (AT III), fibrinogen degradation products (FDP), plasma D-dimer (D-D), prothrombin activator inhibitor-1 (PAI-1), tissue plasminogen activator (t-PA), fibrinogen (FIB) levels and 24-hour urinary protein excretion were measured in three groups.@*Results@#The levels of FIB, AT III%, FDP, D-D, PAI-1 and t-PA in the Henoch-Schonlein purpura group and the Henoch-Schonlein purpura nephritis group[(2.89±0.76)g/L, (3.51±0.81)g/L; (145.72±8.46)%, (163.24±9.05)%; (1.31±0.67)mg/L, (1.54±0.72)mg/L; (0.87±0.52)mg/L, (1.18±0.67)mg/L; (66.47±2.58)ng/L, (91.02±3.24)ng/L; (16.34±0.98)μg/L, (12.35±1.06)μg/L]were higher than those in the control group[(1.88±0.54)g/L, (119.48±8.92)%, (0.92±0.33)mg/L, (0.32±0.18)mg/L, (31.25±3.02)ng/L, (6.82±0.75)μg/L](t=9.256, 18.236, 4.462, 8.540, 75.760, 65.912; 14.306, 29.423, 6.688, 10.591, 115.297, 36.387, all P<0.05). The levels of FIB, AT III%, FDP, D-D and PAI-1 in theHenoch-Schonlein purpura nephritis group were higher than those in the Henoch-Schonlein purpura group (t=4.769, 12.083, 1.998, 3.123, 50.644, all P<0.05), and t-PA in the Henoch-Schonlein purpura nephritis group was lower than that in Henoch-Schonlein purpura group (t=23.165, P<0.05). The 24-hour urinary protein excretion in theHenoch-Schonlein purpura nephritis group[(1.48±0.89)g/24h]was higher than that in the Henoch-Schonlein purpura group[(0.11±0.02)g/24h] and control group[(0.10±0.05)g/24h](t=13.149, 13.227, all P<0.05). There was no statistically significant difference between Henoch-Schonlein purpura group and control group (t=1.587, P>0.05). The 24-hour urinary protein excretion was positively correlated with AT III%, FDP, D-D and IL-33 in patients with Henoch-Schonlein purpura nephritis (r=0.502, 0.546, 0.483, all P<0.05), but not correlated with FIB, PAI-1 and t-PA (r=0.189, 0.213, -0.175, all P>0.05).@*Conclusion@#Patients with purpuric nephritis are in a state of hypercoagulability and hyperfibrinolysis, and coagulation and fibrinolysis disorders are closely related to renal damage in patients.
ABSTRACT
Plasma levels of antithrombin III activity were tested during pregnancy in a control group of normal pregnancies and in study groups that included patients with chronic hypertension, mild preeclampsia, and severe preeclampsia. The mean antithrombin III acticity (+ SD) among normal pregnancies, chronic hypertension, mild preeclampsia and severe preeclamsia was 137.3 + 20.48, 136.14 + 7.82, 120.3 + 12.98, and 116.3 + 11.81% respectively. Significant differences were found in antithrombin III activity between normal pregnancies and mild preeclampsia, normal pregnancies and severe preeclampsia, chronic hypertension and mild preeclampsia, chronic hypertension and severe preeclampsia were significantly different. However, no significant differences in antithrombin III activity were found in chronic hypertension and normal pregnancies, mild and severe preeclampsia. It can be concluded that antithrombin III activity is decreased in preeclampsia, but not in chronic hypertension, and so the measurement may serve as an adjunct to differentiate between a pregnancy complicated with chronic hypertension and one with preeclampsia. However, the severity of preeclampsia cannot be clearly determined by antithrombin III activity levels