己酮可可碱对初治的原发性肾病综合征高凝状态和尿蛋白的影响

目的 :观察己酮可可碱对初治的原发性肾病综合征患者高凝状态的影响和协同降低尿蛋白的疗效。方法 :将初治的原发性肾病综合征患者 6 2例随机地分为 2组 :A组 (己酮可可碱 4 0 0mg/日静脉滴注治疗组 ) ,B组(肝素 75mg/日静脉滴注对照组 ) ,进行强的松和常规的肾病综合征治疗 ,疗程中都不使用其他如潘生丁等影响纤溶凝血系统的药物 ,不使用环磷酰胺等免疫抑制剂。分别于用药前和用药后 1 4天观察凝血、尿蛋白、血浆白蛋白等指标及其不良反应。结果 :6 1例患者完成试验 ,其中A组 30例 ,B组 31例 ,B组中有 1例患者因皮下出血进行性加重而在用药第 7天提前结束疗程退出试验。两组患者的蛋白尿水平在用药前无显著性差异 ;治疗前后两组患者的尿蛋白均有明显下降 ,较用药前有显著的统计学差异 (P <0 0 5 ) ;尤其是伴有纤溶凝血障碍的患者其蛋白尿的降低尤为明显。治疗过程中未观察到己酮可可碱的明显的副作用。结论 :己酮可可碱可以通过改善肾病综合征患者的纤溶凝血系统而在初治的原发性肾病综合征患者中具有和肝素相似的协同降低尿蛋白的作用

Effect of Pentoxifylline on Hypercoagulation and Proteinuria in First Treatment Patients with Primary Nephrotic Syndrome

Objective:To study the effect of Pentoxifylline on hypercoagulation and proteinuria in first choice of patients with primary nephrotic syndrome.Methods:62 patients with primary nephrotic syndrome were divided into two groups randomly:A group(Pentoxifylline 400mg/d),B group(heparin 75mg/d),all patients were treated with prednisone and traditional treatment of primary nephrotic syndrome,without persantin and CTX.We observed the index of coagulation,proteinuria,plasma albumin and bad before test and after fourteenth day.Results:61 patients completed the test,30 patients in A group,and 31 in B group.Before the test,the level of the protemuria between the two groups was similar,however after the treatment,the protemuria of two groups reduced( P <0 05),especially the patient with disorder in coagulation and fibrinogenolysis.In the process,no side effect of Pentoxifylline was found.Conclusion:Pentoxifylline is same as heparin in the role of decreasing amount of proteinuria in primary nephrotic syndrome when used as first line of treatment.Pentoxifylline is safe and plays an important role in improving hypercoagulation condition as well as decreasing degree of proteinuria.