小児微小変化型ネフローゼ症候群における血液凝固・線溶動態 : 第1報 thrombin-antithrombin Ⅲ complex (TAT), D-dimer および Plasmin-α2Plasmin inhibitor complex (PIC) の動態

Abstract

Thrombin-antithrombin Ⅲ complex (TAT), D-dimer and plasmin-α₂plas- min inhibitor complex (PIC) were investigated in 35 children with minimal change ne- phrotic syndrome (MCNS) ; 25 cases during the initial episode and 26 cases during the course of relapse, including 16 overlapping cases. Plasma TAT levels were 7.6±8.0 ng/ml (mean±SD) at initial onset and 1.7±1.9 ng/ml at relapse. Both were higher than those of normal control (≦2.0 ng/ml). Plasma levels of D-dimer were 154±102 ng/ml at initial onset, which were higher than those of normal control (31±15 ng/ml), and 27±24 ng/ml at relapse which were within the normal range. Plasma PIC levels were 0.95±1.25 μg/ml at initial onset and 0.40±0.26 μg/ml at relapse. Both were not significantly different from those of normal control (0.27±0.18 μg/ml). High levels of TAT and D-dimer in the patients with nephrotic syndrome were evidence of thrombin synthesis, and normal PIC levels showed relative hypofibrinolysis and thrombotic risk. There have been no thrombotic events in all cases, so our cases seem to have been under the subtle balance of hemostasis.