低分子肝素钠治疗慢性肾小球肾炎蛋白尿疗效观察

目的观察低分子肝素钠(LMWH)治疗慢性肾小球肾炎蛋白尿的有效性和安全性.方法56例慢性肾小球肾炎伴持续性蛋白尿大于2.5 g/24 h患者,分成两组.两组患者原治疗方案(包括激素其它免疫抑制剂、苯那普利及利尿剂)不变.LMWH治疗组在上述药物治疗基础上加用LMWH皮下注射,每次5000 U,每日2次,共8周.结果LMWH治疗组尿蛋白下降、血清白蛋白回升,血脂、肾功能改善均优于对照组(P＜0.01,P＜0.05);LMWH治疗组FIB、D-二聚体下降与对照组比较差别有极显著意义(P＜0.01);两组BPC、PT、APTT比较差别无显著意义(P＞0.05).LMWH治疗组6例出现皮下淤斑.结论LMWH可以减少慢性肾小球肾炎蛋白尿、升高血清白蛋白,降低血脂及改善肾功能,而且出血危险减少,无需特殊监护,便于长期使用.

Effects of Low-molecular-weight Heparin on Proteinuria in Patients with Chronic Glomerulonephritis

Objective: To investigate the effectiveness and Safety of LMWH on proteinuria in patients with chronic glmerulonephritis. Materials and Methods: Fifty - six patients with chronic golmerulonephritis and stable proteinuria exceeding 2. 5 g/24 h were divided into two groups. The original scheme for treatment of the patients in two groups were unchanged, including steroid and other immune inhibitors, bennazipril, diuretic drug. The patients in the treated group were given LMWH 5000u Bid, 8 w, additionally. Results: A significant decrease in proteinuria, and increase in serum albumin were observed in the treated group. Hemolipids and renal function were also improved. (P <0. 01, P <0. 05) A significant decrease of FIB and two - Dimer were observed in comparing with the control group (P < 0. 01 ). Changes of BPC , PT and APTT of the patients in two groups were not significant (P > 0. 05). Six patients in the treated group appeared subcutaneous ecchymosis. Conclusion: LMWH can decrease the proteinuria and hemolipids, increase serum albumia and improve the renal function in the patients with chronic glomerulonephritis. Because of the less risk of hemorrhage, LMWH can be used for long - term treatment to prevent glomerulosclerosis and the process of renal function loss without special mornitoring.