肾病综合征患者抗凝治疗中血液指标的变化

目的:对肾病综合征患者进行LMWH 抗凝治疗,研究它的疗效及对患者血液指标的影响.方法:对我院确诊的肾病综合征患者随机分为对照组35 例,常规使用糖皮质激素等药物,观察组35 例,在常规用药基础上加用LMWH 抗凝药物,测定TCH 、TG 、LDL-C 、HDL-C 、ApoA1 、ApoB 、ALB 、TP 、PLT 参数、凝血指标、24 小时尿UP 定量.结果:1 、组内比较:两组患者治疗后24 小时UP 、TG 、TCH 、LDL-C 、ApoB 、PLT 、MPV 、PDW 降低,ALB 、TP 、HDL-C 水平均升高,PT 、APTT 、TT 时间延长,Fib 水平降低,与治疗前比较,差异均有统计学意义(P<0.05); 组间比较:观察组24 小时UP 、TG 、TCH 、LDL-C 、ApoB 下降更低,ALB 、TP 、HDL-C 上升更高,PT 时间延长,与对照组比较,差异均有统计学意义(P<0.05).结论:对肾病综合征患者进行LMWH 抗凝治疗,可改善高凝状态和血液流变学失常,增加肾小球负电荷屏障,减少尿蛋白,抑制肾小球系膜细胞、基质增生,减少出血,值得临床应用.

Influence of Low Molecular Weight Heparin on The Blood Parameters of Patients With Nephrotic Syndrome

Objective:To study the efficacy and impact on blood parameters by LMWH therapy in patients with nephrotic syndrome.Methods:Patients with nephrotic syndrome diagnosed in our hospital were randomly divided,35 cases of control group,the routine use of corticosteroids and other drugs,35 cases of observation group was given anticoagulant therapy with LMWH on the basis of conventional medication,determined TCH,TG,LDL-C,HDL-C,ApoA1,ApoB,ALB,TP,PLT,coagulation indicators and 24-hour urine UP.Results:1.24 hours after treatment,the UP,TG and TCH,LDL-C,ApoB,PLT,MPV and PDW were lower,ALB,TP,HDL-C increased by an average,PT,APTT and TT Prolonged.Fib level lower,there were statistically significant between before and after treatments(P<0.05);2.Observation group 24 hours UP,TG,TCH,LDL-C and ApoB decreased lower,ALB,TP and HDL-C rose higher,PT prolonged,compared with the control group,there were statistically significant(P<0.05).Conclusion:LMWH anticoagulation therapy in patients with nephrotic syndrome,improve the hypercoagulable state and hemorheological disorders,increased glomerular negative charge barrier,reduced urinary protein,inhibition of glomerular mesangial cells and stromal hyperplasia,reduced bleeding,be worthy of clinical application.