Changes of coagulation and fibrinolysis system in children with Henoch-Schonlein purpura nephritis and its clinical significance / 中国基层医药

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.