中国血液净化

›› 2003, Vol. 2 ›› Issue (8): 433-435.

• 论著 • 上一篇    下一篇

低分子肝素对原发性肾病综合征的辅助治疗作用

李 健 林新广 初启江 耿 云 郝俊玲   

  1. 264200 威海，山东省威海市立医院肾内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2003-08-19 发布日期:2003-08-19

  • Received:1900-01-01 Revised:1900-01-01 Online:2003-08-19 Published:2003-08-19

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摘要： 目的 观察低分子肝素辅助治疗原发性肾病综合征的疗效及安全性。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(4000 IU)腹部皮下注射，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）、部分凝血活酶时间（APTT）、凝血酶时间(TT)、纤维蛋白原（FIB）、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，两组患者临床症状均减轻或消失，治疗组总有效率（96.6%）高于对照组（89.3%）。治疗后两组患者尿蛋白减少，血浆白蛋白升高，总胆固醇、甘油三酯下降，血液粘度降低(P<0.05，P<0.01）； 在减轻蛋白尿、升高血浆白蛋白、降低血液粘度方面， 治疗组优于对照组 (P< 0.05，P<0.01）；治疗后两组患者的 PT、TT延长，FIB下降(P<0.05，P<0.01），但治疗组更明显，与对照组比较（P<0.05，P<0.01）， APTT延长，但两组间无差异（P>0.05）；两组治疗后血小板数虽有下降，但治疗前后比较无差异（P>0.05）；两组患者中无一例有出血倾向。结论 低分子肝素辅助治疗原发性肾病综合征，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，并具有很好的安全性。

关键词: 低分子肝素, 原发性肾病综合征, 治疗

Abstract: Objective To observe the therapeutic effect and security of low molecular weight heparin(LMWH) on primary nephrotic syndrome. Methods Prednisone and other drugs were used in both control group and treatment group. LMWH(4000IU) abdomen hypodermal injection was used in treatment group. Twenty-four hour urinary protein, plasma albumin, tolal cholesterol, triglyceride, blood viscosity, thrombin time (TT), partial thromboplastin time(APTT), prothrombin time(PT), fibrinogen(FIB), platelet count were tested in both groups before and after treatment. Results The clinical symptoms relieved or disappeared in two groups after 4 weeks treatment, the effective rate in treatment group (96.6%) is significantly higher than that in control group (89.3%). The urinary protein decreased, plasma albumin elevated, tolal cholesterol, triglyceride decreased, blood viscosity decreased (P<0.05; P<0.01); treatment group excelled control group in decreasing albuminuria, elevating plasma albumin and decreasing blood viscosity (P<0.05 ; P<0.01) . After treatment the PT, TT prolonged and FIB decreased in both groups ( P<0.05; P<0.01); but the treatment group is more evident than control group. APTT prolonged and platelet decreased in two groups, but there was no significant difference between two groups. There was no hemorrhagic tendency in two groups. Conclusion LMWH treatment can improve nephrotic syndrome patient's hypercoagulability state, decrease blood viscosity, and relieve urinary protein, elevate plasma albumin. Our results showed that LMWH and enhanced the efficiency is safe.

Key words: Primary nephrotic syndrome, Treatment