低分子量肝素治疗糖尿病肾病的临床研究

目的观察低分子量肝素治疗糖尿病肾病的临床疗效和安全性。方法将 6 4例糖尿病肾病患者根据 2 4h尿白蛋白或蛋白定量分为早期糖尿病肾病 (30例 )和临床期糖尿病肾病 (34例 ) ,再随机分为治疗组和对照组。所有患者均给予降糖降压治疗 ;治疗组再予以低分子量肝素治疗 ,疗程 8周 ,观察血脂、血小板、纤维蛋白原、凝血酶原标准化比率、肝肾功能、内生肌酐清除率、2 4h尿白蛋白或蛋白定量变化及副作用。结果两期治疗组疗程后 ,血脂、胆固醇、纤维蛋白原、2 4h尿白蛋白或蛋白定量下降 ;临床糖尿病肾病治疗组血尿素氮、肌酐降低 ,内生肌酐清除率升高与治疗前及对照组治疗后比较均有显著性差异 (P <0 .0 1或 0 .0 5 )。结论低分子量肝素可安全有效的用于糖尿病肾病的临床治疗。

Clinical study of low-molecular weight heparin in treating diabetic nephropathy

Objective To investigate the clinical efficacy and safety of low-molecular weight heparin(LMWH) on diabetic nephropathy(DN). Methods 64 DN cases were divided into incipient DN(30 cases) and overt DN(34 cases) based on 24-hour urine albumin and protein, who were randomly subdivided into treatment group and control group. All the patients were treated by blood glucose control and blood pressure control. In the meantime, the patients in the treatment group were given LMWH additionally, for a course of 8 weeks for the observation of serum lipid, PLT, FIB, PT-INR, hepatic and renal function, creatinine clearance(Ccr), quantity of albumin or protein in 24-hour urine and side effects in the two groups. Results Seurm lipid, FIB and quantity of albumin or protein in 24-hour urine decreased in the treatment group. Bun and Cr decreased while Ccr increased in ODN group, with a significant difference before and after treatment(P<0.01 or P<0.05). Conclusion LMWH is effective and safe in treating DN.