低分子肝素治疗糖尿病肾病的疗效观察

目的:观察低分子肝素治疗糖尿病肾病的临床疗效和安全性。方法:将64例糖尿病肾病患者根据24h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、24h尿白蛋白或蛋白定量变化及副作用。结果:两期治疗组治疗后血脂、纤维蛋白原、24h尿白蛋白或蛋白定量下降,临床期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,治疗前及对照组治疗后比较差异均有统计学意义(P<0.01,P<0.05)。结论:低分子肝素治疗糖尿病肾病安全有效。

Clinical study of low molecular weight heparin in treating diabetic nephropathy

Objective:To investigate the clinical effects and safety of low-molecular-weight hep-arin(LMWH)on diabetic nephropathy(DN).Methods:According to the quantity of albumin or pro-tein in24-hour urine,64DN patients were divided into two groups:incipient DN(30cases)and overt DN(34cases),and then they were divided randomily into therapy and control groups.All the patients were given treatment to control blood glucose and blood pressure.In the meantime,patients in the therapy group were given LMWH additionally for8weeks.During the treatment,serum lipid,PLT,FIB,PT-INR,hepatic and renal function,creatinine clearance(Ccr),quantity of albumin or protein in24-hour urine and side effects of two groups were observed and recorded.Result:Serum lipid,FIB and quantity of albumin or protein in24-hours urine decreased in the therapy group.Bun and Cr decreased while Ccr increased in ODN therapy group.There was a significiant difference between two groups(P<0.01or P<0.05).Conclu sion:LMWH is effective and safe in the treatment of DN.