Objective To study the coagulation status in patients with nephrotic syndrome with different plasma albumin(ALB)levels.Methods 60 patients with nephrotic syndrome were retrospectively selected and divided into 25-30 g/L albumin group,20-25 g/L albumin group,albumin<20 g/L group and normal control group according to different plasma albumin levels,with 15 cases in each group.The coagulation indices[D-dimer(D-D),fibrinogen(Fg),procalcitonin(PCT),activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),platelet count(PLT),platelet distribution width(PDW),and mean platelet volume(MPV)]were detected in the four groups.The coagulation indices of the four groups were statistically compared,and the correlation of albumin with D-D and Fg was analyzed.Results In albumin 25-30 g/L group,D-D,Fg,PCT,APTT,PT,TT,PLT,PDW and MPV were(0.64±0.14)μg/ml,(5.32±1.13)g/L,(0.24±0.07)ng/ml,(36.25±0.67)s,(12.77±0.43)s,(17.58±1.18)s,(230.23±10.14)×109/L,(12.32±0.45)fl and(10.52±0.22)fl;in albumin 20-25 g/L group,they were(0.65±0.14)μg/ml,(5.35±1.25)g/L,(0.25±0.06)ng/ml,(36.64±0.72)s,(12.95±0.34)s,(17.66±1.22)s,(231.22±13.56)×109/L,(12.02±0.42)fl and(10.45±0.12)fl;in albumin<20 g/L group,they were(1.14±0.03)μg/ml,(6.80±1.53)g/L,(0.27±0.11)ng/ml,(37.26±0.83)s,(13.20±0.30)s,(18.78±1.70)s,(272.23±11.23)×109/L,(11.62±0.45)fl and(10.25±0.14)fl;in normal control group,they were(0.14±0.04)μg/ml,(2.83±0.48)g/L,(0.20±0.10)ng/ml,(34.78±2.55)s,(12.01±0.58)s,(16.60±0.80)s,(221.23±12.05)×109/L,(12.65±0.41)fl and(11.14±0.52)fl.The plasma D-D,Fg,APTT,PT,TT and PLT of albumin<20 g/L group,albumin 20-25 g/L group and albumin 25-30 g/L group were decreased gradually,and were higher than that of normal control group;the plasma D-D,Fg,APTT,PT,TT and PLT of albumin 20-25 g/L group and albumin 25-30 g/L group were lower than those of albumin<20 g/L group(P<0.05).The PDW and MPV of albumin<20 g/L group,albumin 20-25 g/L group and albumin 25-30 g/L group were all increased gradually,and were lower than the normal control group;the PDW and MPV of albumin 20-25 g/L group and albumin 25-30 g/L group were higher than those of albumin<20 g/L group(P<0.05).However,there were no significant differences in plasma D-D,Fg,APTT,PT,TT,PLT,PDW and MPV between albumin 20-25 g/L group and albumin 25-30 g/L group(P>0.05).There was no difference in PCT among the four groups(P>0.05).There was a significant negative correlation between albumin and D-D and Fg(r=-0.262,-0.410;P<0.05).Conclusion Patients with nephrotic syndrome have different coagulation states with different levels of plasma albumin.Patients with albumin<20 g/L are more likely to have a hypercoagulable state.Patients with nephrotic syndrome with albumin of 25-30 g/L also need a comprehensive assessment of the coagulation state and preventive anticoagulant therapy to reduce the occurrence of thrombosis and improve the prognosis of patients.
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