Study on coagulation status in patients with nephrotic syndrome with different plasma albumin levels
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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