Background

Thromboembolism is one of the most important and dangerous complications of nephrotic syndrome. This study aimed to determine the value of albumin, anti-thrombin III, fibrinogen and D-dimer factors in the prediction of asymptomatic pulmonary embolism in patients with nephrotic syndrome in non-remission period.

Methods

Plasma levels of albumin, anti-thrombin III, fibrinogen and D-dimer were assessed in 30 nephrotic children in non-remission period (including new case–patient or relapse period), and the results were compared with chest X-ray and lung perfusion scintigraphy (Q scan).

Results

The mean age of patients was 6.22 ± 3.5 years (range 2–12 years). Of patients, 23.3% had abnormal findings in perfusion scan suggestive of pulmonary emboli despite absence of any respiratory manifestations. Median plasma albumin and anti-thrombin III levels in patients with asymptomatic pulmonary embolism were lower than in patients without pulmonary embolism. Also, median fibrinogen and D-dimer levels in patients with asymptomatic pulmonary embolism were higher than in patients without pulmonary embolism, with no statistically significant differences between sex, age, hemoglobin and hematocrit of patients and lung perfusion scan results.

Conclusion

Patients with abnormal blood levels of albumin (< 3.5 g/dl), anti-thrombin III (< 80 ml/dl), fibrinogen (> 400 ml/dl) and D-dimer (> 0.5 μg/dl) underwent CXR/Q scan and were treated with heparin if there was pulmonary embolism.

中文翻译：

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白蛋白、抗凝血酶Ⅲ、纤维蛋白原和D-二聚体因子对肾病综合征患者无症状肺栓塞诊断价值的测定

背景

血栓栓塞是肾病综合征最重要和最危险的并发症之一。本研究旨在确定白蛋白、抗凝血酶III、纤维蛋白原和D-二聚体因子在预测非缓解期肾病综合征患者无症状肺栓塞中的价值。

方法

对 30 名非缓解期（包括新发病例或复发期）肾病患儿的血浆白蛋白、抗凝血酶 III、纤维蛋白原和 D-二聚体水平进行评估，并将结果与​​胸部 X 线和肺灌注情况进行比较闪烁扫描（Q 扫描）。

结果

患者的平均年龄为 6.22 ± 3.5 岁（范围 2-12 岁）。尽管没有任何呼吸系统表现，但 23.3% 的患者在灌注扫描中发现提示肺栓塞的异常结果。无症状肺栓塞患者的中位血浆白蛋白和抗凝血酶 III 水平低于无肺栓塞患者。此外，无症状肺栓塞患者的纤维蛋白原和 D-二聚体中位数水平高于无肺栓塞患者，患者的性别、年龄、血红蛋白和血细胞比容与肺灌注扫描结果之间无统计学差异。

结论

白蛋白 (< 3.5 g/dl)、抗凝血酶 III (< 80 ml/dl)、纤维蛋白原 (> 400 ml/dl) 和 D-二聚体 (> 0.5 μg/dl) 血液水平异常的患者接受 CXR/Q如果有肺栓塞，扫描并用肝素治疗。