肾病综合征合并肺栓塞的临床研究进展

肾病综合征是一种临床常见疾病，其患者体内常呈高凝状态，极易发生血栓栓塞事件，而其中以肾静脉血栓、肺动脉栓塞和下肢深静脉血栓最为常见。由于肺动脉栓塞早期缺乏特征性的临床表现，病情隐匿，所以极易误诊或漏诊，发现时患者病情往往已十分严重，致死率极高。目前，对于肾病综合征合并肺栓塞的发生率国内外报道不一，尚无准确的流行病学资料，而对于其发病原因、危险因素、早期诊断及是否需要预防性抗凝治疗等均存在争议，本文主要结合文献对肾病综合征合并肺栓塞的流行病学、病因及发病机制、诊断、高危因素和治疗进行了综述，尤其是对目前争议较大的肾病综合征合并肺栓塞患者是否需要早期抗凝治疗。

Clinical Research Progress of Pulmonary Embolismin Nephrotic Syndrome

Nephrotic syndrome is a common clinical disease. Patients with nephritic syndrome are often in the hpercoagulablestate. Renal vein thrombosis, pulmonary embolism and deep vein thrombosis are the most common thromboembolism diseases. Amongthem, pulmonary embolism is the most dangerous because of its high mortality. Due to the lack of obvious and characteristic clinicalmanifestation in the early stage, pulmonary embolismis prone to be misdiagnosed or never diagnosed. However, the epidemiological datareported of nephrotic syndrome with pulmonary embolism shows no consistency at home and abroad, there is still debate about the causeof disease, risk factors, early diagnosis and the need for anticoagulation therapy. The purpose of this essay is to describe theepidemiology, pathophysiological mechanisms, diagnosis and treatment of pulmonary embolism in patients with nephrotic syndrome,especially for the present controversial about the necessity of early anticoagulation therapy of patients with nephrotic syndromecomplicated with pulmonary embolism.