低分子肝素治疗原发性肾病综合症的疗效观察

目的:观察低分子肝素治疗原发性肾病综合症的疗效及安全性.方法:对照组常规应用强的松及其它药物,治疗组在对照组用药的基础上加用低分子肝素(5000IU)皮下注射.两组治疗前后分别检测24小时尿蛋白、血浆白蛋白、总胆固醇、甘油三酯、血液流变学、凝血酶原时间(PT)、部分凝血酶时间(APTT)、凝血酶时间(TT)、血小板计数,并观察临床症状改善情况及有无出血倾向.结果:经4周治疗,两组患者临床症状减轻或消失,治疗组总有效率(96.2%),高于对照组(88.0%).治疗后两组患者尿蛋白减少,血浆白蛋白升高,血液粘度降低(P＜0.05,P＜0.01),治疗组优于对照组(P＜0.05,P＜0.01);治疗后两组患者的APTT延长、血小板数量下降,但治疗前后比较无差异(P＞0.05),两组患者中无1例有出血倾向.结论:低分子肝素治疗原发性肾病综合症可以更好地改善患者的高凝状态,降低血液粘度,减轻蛋白尿,提高血浆白蛋白,明显地增加疗效,并有很好的安全性.

OBSERVATION OF EFFECT OF LOW MOLECULAR WEIGHT HEPARIN ON PRIMARY NEPHROTIC SYNDROME

Objective: To observe the the r apeutic effect and safety of low molecular weight heparin(LMWH) on primary nephr otic syndrome. Methods: Prednisone and other drugs were used in both the control group and the treatment group. LMWH(5000IU) hypodermal injection was applied in treatment group. Twenty-four hour urinary protein, pla sma albumin, tolal cholesterol, triglyceride, blood viscosity, prothrombin time( PT), partial thromboplastin time(APTT), thrombin time(TT), and platelet count we re tested in both groups before and after treatment. Results: The clinical symptoms were relieved or disappeared in two groups after 4 w eeks treatment, and the effective rate in treatment group(96.2%) is significant ly higher than that in control group(88.0%). Treatment group excelled control gr oup in decreasing albuminuria, elevating plasma albumin and decreasing blood vis cosity(P<0.05,P<0.01);after treament APTT prolonged a nd platelet decreased in two groups, there was no significant difference found b etween two groups(P>0.05). There was no hemorrhagic tendency in t wo groups. Conclusions: LMWH treament can improve nephro tic syndrome patient's hypercoagulability state, decrease blood viscosity, relie ve urinary protein, and elevate plasma albumin. Our results showed that LMWH enh anced the efficiency and was safe.