原发性肾病综合征伴高粘滞血症患儿血液流变学变化及川芎嗪疗效观察

目的:观察原发性肾病综合症(PNS)伴高粘滞血症患儿血液流变学变化并探讨川芎嗪的临床疗效。方法:将确诊有高粘血滞症的PNS患儿随机分为川芎嗪组(21例)和对照治疗组(19例),川芎嗪组予川芎嗪5-8mg·kg~(-1)·d~(-1)。两组均同时服用强的松2mg·kg~(-1)·d~(-1),治疗8周。治疗前后检测并分析血液流变学各项指标的变化,观察蛋白尿转阴、水肿消退时间。结果:治疗前,两组各项血液流变学指标明显高于正常组。治疗后,川芎嗪组蛋白尿转阴,水肿消退时间较对照组明显缩短(P<0.05、P<0.01)。同时血液流变学大部分指标较对照组下降(P<0.05),与正常组基本无差别(P>0.05),而对照组大部分指标仍高于正常组。结论:大部分PNS患儿存在高粘滞血症,川芎嗪可降低血粘度而改善症状,缓解PNS的发展。

Change of Hemorrheology in Children with Primary Nephrotic Syndrome in Association with Hyperviscosemia and the Treatment Effect of Ligustrazine for the Disease

Objective:To study the changes of hemonheology in children with primary nephrotic syndrome (PNS) associated with hyperviscosemia and to evaluate the effects of ligustrazine in treating the disease. Methods: The patients diagnosed as hyperviscosemia were randomly divided into two groups:Group A (treated with ligustrazine, n = 21)and group B (control, n = 19) .5- 8mg·kg·d-1 of ligustrazine was given to group A and 2mg · kg-1 · d-1 of prednisone was given to both groups for 8 weeks. The changes of hemorrheol-ogy were analysized and the times of disappearance of proteinuria and skin edema were observed. Results: Before treatment all indications of hemorrheology in PNS in both groups were significantly higher than that in normal group. Following the treatment, most hemor-rheology indications decreased significantly in group A compared with that in group B ( P < 0.05) , and there was no difference compared with normal group ( P > 0.05), group A showed evidence of controlling the disease (P<0.05,P<0.01). Conclusion: The children with PNS tend to suffer from hyperviscosemia. Ligustrazine may decrease the blood viscosity, improve the symptoms and cut off the development of PNS.