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The purpose of end-stage renal disease (end stage renal disease, ESRD) patients with bleeding and hypercoagulability two tendencies, the clotting mechanism of the complex changes often coexist. Decrease in hematocrit, thrombocytopenia (platelet, PLT) adhesion, aggregation function decline or abnormalities of the vascular wall, so that patients with prolonged bleeding time, prone to a variety of bleeding risk. While part of clotting factor activity increased fibrinolytic system dysfunction, are also vulnerable to the formation of microthrombi. This study was designed to confirm the presence of a hypercoagulable state and bleeding tendency common coagulation indicators and PLT parameters by ESRD patients detected explore the normal population, ESRD dialysis patients with hemodialysis patients with bleeding and clotting function did not change, as well as different age their presence or absence and gender, and to explore the clinical judgment ESRD patients with or without thrombosis and bleeding tendency laboratory reference index. Recorded 60 cases of ESRD patients and 30 healthy age and gender, were measured platelet number (PLT), mean platelet volume (MPV), platelet distribution width (PDW), prothrombin time (PT) and activated partial thromboplastin thromboplastin time (APTT), thrombin time (TT), fiber Fib (FIB), D-dimer (DD) and blood clots flinch test. All subjects were doing vascular ultrasound examination. Of all cases of age greater than 75 years of age (19-74 years, mean 48.7 years) and there is no obvious infection and (or) acute vasculitis. Hematological malignancies, liver damage, to exclude the original thrombotic diseases, cardiovascular diseases, and unwilling participant. Completion of the application SPSS13.0 software for statistical analysis. Measurement data are mean plus or minus standard deviation, using t test, count data using χ2 test. One-Way ANOVA analysis, the correlation between the application of a simple linear, P lt; 0.05 was considered statistically significant. Results of the comparison between the experimental and control groups: the experimental group patients with normal control group, the coagulation indicators t-test, two sets of the PLT, PT, FIB pairwise comparison, t values ??were 3.44,6.63,3.25, P lt ; 0.01, there are statistically significant. Table 1.2 DD-positive normal control group, the experimental group DD-positive and 36 (60%). Prompted ESRD patient's body at the same time there is a tendency to bleed and hypercoagulable state. All subjects 24 hours clot retraction test and are in full retreat. Clot retraction test is not sensitive enough to reflect platelet dysfunction. Venous ultrasonography of the normal control group showed no abnormality in the experimental group were not found in the presence of venous thrombosis, atherosclerosis plaque 6 patients (10%). . Hemodialysis group and non-dialysis group compared with the control group: ESRD not dialysis group than in the control group, PLT, APTT, PT, TT decreased significantly higher, FIB, the dialysis set of PLT, PT compared with the control group decreased, FIB was significantly higher; dialysis group the APTT than that dialysis was significantly shortened. Table 2. Prompt hemodialysis can not effectively improve their hypercoagulable state. 2. Hemodialysis, and not dialysis group, PLT, PT have significantly shorter, FIB was significantly higher. Shown in Table 2. 3 of ESRD patients FIB whether dialysis was significantly higher (P lt; 0.01). The dialysis group DD 22 positive, accounting for 57.89%; dialysis group DD positive 12 people, accounting for 54.55%, χ2 = 10.29, P lt; 0.01, statistically significant in Table 2.4. D-dimer reflect ESRD patients out coagulopathy. According to age into youth group, the middle-aged group, the older group: three sets of pairwise comparisons the PLT of MPV, PDW, APTT, PT, TT, FIB, there were no statistically significant differences. Table 3. Prompted age on ESRD patients no significant effect on the clotting abnormalities. Four. Grouped according to sex: male, female PLT, MPV, PDW, APTT, PT, FIB comparison between the two groups, the t values ??were 0.0274,0.0084,0.1286,0.1002,0.7704,0.0551, P are lt; 0.05, no statistically significant. Display gender ESRD patients out clotting abnormalities had no significant effect. 2 male DD positive 28 people, accounting for 60.87%; female DD positive people, accounting for 57.14%, χ2 = 8.062, P lt; 0.01 statistically significant. All selected for the experimental group patients 24 hours a blood clot retreat are fully displayed clot retraction test is used to reflect the abnormal platelet function is not sensitive enough. Not found the presence of venous thrombosis of the lower limbs, prompted ESRD patients with a low incidence of deep vein thrombosis, even if the patients coagulopathy. The results of this study show: 1 of ESRD patients body at the same time there is a tendency to bleed and hypercoagulable state. Maintenance hemodialysis can not be effective in improving the patient's hypercoagulable state. Age of ESRD patients no significant effect on the clotting abnormalities. 4. Gender ESRD patients with no significant effect on the clotting abnormalities. 5.D-dimer reflect ESRD patients out coagulopathy. Clot retraction test is not sensitive enough to reflect ESRD patients coagulopathy. 7 of ESRD patients with a low incidence of deep vein thrombosis, even if the patients with a coagulation disorder.
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