低分子肝素治疗妊娠期肾病综合征高凝状态的研究

目的观察低分子肝素(LMWH)对妊娠期肾病综合征(NSP)高凝状态的疗效。方法将54例孕28～32周发病的NSP患者随机分为两组,各27例。肝素组接受常规治疗的同时加用LMWH治疗,对照组接受常规治疗。观察两组患者治疗前后凝血酶原时间等凝血指标及产后出血量的变化。结果对照组凝血指标治疗后与治疗前相比差异无统计学意义(P>0.05),肝素组凝血酶原时间、活化部分凝血活酶时间治疗后较治疗前延长,D-二聚体、纤维蛋白原较治疗前减少,血浆抗凝血酶Ⅲ增加,差异有统计学意义(P<0.05);肝素组治疗后均未出现出血倾向及产后出血增多等不良反应。结论LMWH可以减轻NSP时的高凝状态,未增加出血风险。

Therapeutic Effect of Low Molecular Weight Heparin on Hypercoagulation State in Nephrotic Syndrome of Pregnancy

Objective To observe the therapeutic effect of low molecular weight heparin(LMWH)on hypercoagulation state in nephrotic syndrome of pregnancy(NSP).Methods 54 patients of nephrotic syndrome of pregnancy at 28-32 gestational weeks were randomly divided into control group and heparin group.On the basis of the conventional treatments,heparin group(27 cases)was additionally treated by LMWH.Control group(27 cases)was given only conventional treatments.The changes of coagulation index and the amount of postpartum hemorrhage were analyzed before and after treatment.Results There were no significant differences of coagulation index in the control group before and after treatment(P>0.05).In heparin group,prothrombin time and activation of partial thromboplastin time were longer,D-dimer and fibrinogen were lower and antithrombin Ⅲ was increased after treatment,and the differences were significant(P<0.05).Bleeding tendency and postpartum hemorrhage were not observed in heparin group.Conclusion LMWH can lighten hypercoagulation state in NSP,without increasing the hemorrhage risk.