低分子肝素钙辅助治疗原发性肾病综合征35例疗效观察

目的观察低分子肝素钙对原发性肾病综合征（PNS）患者的疗效。方法对收治的65例PNS患者随机分为2组，对照组30例采用泼尼松和环磷酰胺治疗，观察组35例则在对照组治疗的基础上加用低分子肝素钙治疗，2周为1个疗程，共2个疗程。观察2组治疗前后血浆白蛋白、尿蛋白、血脂变化，血浆凝血酶原时间、活化部分凝血活酶时间，纤维蛋白原及不良反应等。结果2组患者治疗后血浆白蛋白升高，24h尿蛋白定量减少，血脂下降，与治疗前比较差异有统计学意义（P〈0．05）；观察组治疗后疗效优于对照组（P〈0．01）。观察组治疗后几项凝血指标较治疗前及对照组治疗后均降低，差异均有统计学意义（P〈0．05或P〈0．01）。观察组总有效率94．3％及完全缓解率80．0％显著高于对照组的80．0％，63．3％，差异有统计学意义（P〈0．01）。结论低分子肝素钙辅助治疗原发性肾病综合征可明显提高疗效。

The therapeutic effect of low molecular weight heparin calium on primary nephrotic syndrome:report 35 cases

Objective To observe the effect of low molecular weight heparin calium for patients on primary nephrotic syndrome（PNS）. Methods 65 cases patients were randomly divided into 2 groups. The control group （30 cases）treated with prednisone and cyclophosphamide, while the observation group（35 cases）treated with low molecular weight heparin calium at the bases of the control group,2 weeks as a course of treatment,in all 2 courses. Observed plasma albumin,urine protein,blood lipid changes,plasma prothrombin time, activated partial thromboplastin time,fibrinogen and adverse reactions in two groups before and after treatment. Results After treatment, serum albumin elevated,24h urinary protein reducted, blood lipid droped in patients of two groups, treatment effect of the observation group was better than the control group（ P 〈 0.01 ）, the difference between after treatmeat was significantly （P 〈 0.05 ） ;Plasma prothrombin time, activated partial thromboplastin time, fibrinogen in two groups after treatment were lower than that befort treatment or the control group after treatment, the differences were significantly （ P 〈 0.05 or P 〈 0.01 ）. The total efficiency and complete remission rate in observation group were significantly higher than that in the control group（94.3% and 80.0% vs 80.0% and 63.3% ） , the differences were statistically significant （ P 〈 0.01 ）. Conclusion It can significantly improve the efficacy that used of low molecular weight heparin calium on primary nephrotic syndrome.