Abstract：Objective: To investigate the diagnostic value of the ratio of urinary protein to plasma albumin and plasma TFPI level in patients with membranous nephropathy(MN).Methods: A total of 62 patients with primary MN(n=40)or non-MN(n=22)were selected from Jan to Oct 2018.There were 9 cases of thrombosis in the MN group and 0 case in the non-MN group.All patients had 24 h urine protein quantitation ≥ 3.5 g and plasma albumin<40 g/L.Patients with long-term use of drugs that affect blood clotting,recent history of surgery,long-term bed rest,and immobility for more than 1 week were excluded.Fasting blood was collected in the morning to measure TFPI level,plasma albumin and related clinical indicators.Results: The plasma TFPI level was significantly higher in the MN group than that in the non-MN group(P=0.001),and also significantly higher in the MN with thrombosis group than that in the MN without thrombosis group(P=0.001).Plasma TFPI level was significantly negatively correlated with plasma albumin(r=-0.537,P=0.000),and positively correlated with 24 h urine protein,cholesterol,fibrinogen and platelets(r=0.461,0.357,0.520,0.455 respectively,P<0.05).The ratio of urinary protein to plasma albumin in MN group was significantly higher than that in non-MN group(P=0.013),and the ratio in MN with thrombosis group was significantly higher than that in MN without thrombosis group(P=0.000).The ROC curve showed that the plasma TFPI level had a greater predictive value for thrombosis in MN patients(AUC=0.944).The predictive value of the ratio of urinary protein to plasma albumin for thrombosis was superior to the detection of urine protein and plasma albumin alone(AUC=0.900,0.823,0.806 respectively).Conclusions: MN patients have a feedback increase of TFPI in the hypercoagulable state.Plasma TFPI level has high sensitivity and specificity for the diagnosis of thromboembolism.The ratio of urinary protein to plasma albumin has a good diagnostic value for thromboembolism.
李梦文, 张艳宁. 尿蛋白与血浆白蛋白的比值及血浆TFPI水平对膜性肾病患者血栓诊断的价值[J]. 沈阳医学院学报, 2020, 22(2): 118-122.
LI Mengwen, ZHANG Yanning. The value of the ratio of urine protein to plasma albumin and plasma TFPI level in the diagnosis of thrombosis in patients with membranous nephropathy. Journal of Shenyang Medical College, 2020, 22(2): 118-122.
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2020, Vol. 22 
