Clinical Significance Of VWF And TM In Patients With Primary Glomerular Diseases With Different Pathological Types

Objective: To investigate the levels of plasma von Willebrand factor(vWF)and thrombomodulin(TM)in patients with primary glomerular disease of different pathological types.And to investigate the clinical significance of vWF and TM in patients with primary glomerular disease of different pathological types.Methods: A total of 60 patients with primary glomerular disease(PGD)who underwent renal biopsy from the Department of Nephrology,the First Affiliated Hospital of Bengbu Medical College from January 2016 to October 2016 were selected as the study group.According to the pathological type,30 cases were membranous nephropathy(MN)group and 30 cases of non-membranous nephropathy group.Among them,5 cases of focal segmental glomerulosclerosis(FSGS),mesangial proliferative glomerulonephritis(Ms PGN)8 cases,7 cases of Ig A nephropathy(Ig AN),10 cases of minimal pathological glomerulopathy(MCD).A total of 20 healthy subjects were selected as the control group(NC).The levels of plasma vWF,TM,fibrinolysis index and biochemical indexes were measured and compared.Results:1.The plasma vWF level in the study group was significantly higher than that in the normal control group(P <0.01),and the plasma vWF level in the membranous nephropathy group was significantly higher than that in the non-membranous nephropathy group(P <0.01).3.The plasma TM level in the study group was significantly higher than that in the normal control group(P < 0.01),and the plasma TM level in the membranous nephropathy group was significantly lower than that in the non-membranous nephropathy group(P <0.01).4.The levels of PT and APTT in the study group were significantly lower than those in the normal control group(P < 0.01),and the levels of FIB and D-dimer were significantly higher than those in the normal control group(P <0.01)(P <0.01).Compared with the non-MN group,the levels of PT and APTT in MN group were significantly decreased(P <0.01),and D-dimer level was significantly increased(P<0.01).5.Correlation analysis: Pearson correlation analysis showed that the level of vWF in the study group was negatively correlated with PT,APTT and ALB,and positively correlated with 24 h Upro and D-dimer,and had no significant correlation with age,blood pressure,platelet parameters,TT,FIB,Scr,TC,TG,LDL.In the study group there was no significant correlation between plasma TM level and age,blood pressure,platelet parameters,coagulation function,ALB,FIB,Scr,TC,TG,LDL,24 h Upro and D-dimer.Conclusion:1.Plasma vWF levels can reflect coagulation and prethrombotic status in patients with PGD.Plasma vWF levels were more sensitive than routine coagulation test in reflecting the hypercoagulable state of PGD patients,especially in patients with membranous nephropathy.2.Plasma TM levels can be used as an early indicator of hypercoagulable state in patients with PGD,especially in MN patients.