血栓通治疗小儿肾病综合征高凝状态及高脂血症的临床分析  

Clinical Analysis of Hypercoagulable Status and Hyperlipidemia in Children with Nephritic Syndrome Treated by Panax Notognsens

作　　者：李琪[1] 杨龙[1] 曾洁[1] 齐志业[1] 熊晶晶[1] 徐静[1] 

机构地区：[1]昆明医学院第一附属医院,云南昆明650032

出　　处：《昆明医学院学报》2011年第12期86-89,共4页Journal of Kunming Medical College

基　　金：云南省教育厅基金资助项目(08Z0035)

摘　　要：目的研究血栓通联合肝素对肾病综合症患儿高凝状态及高脂血症的影响.方法选择诊断为原发性肾病综合征并存在高凝状态和高脂血症的住院患儿128例,均给予足量泼尼松[2 mg/(kg.d),最大剂量60mg/d)]治疗,并随机分为肝素组[泼尼松+肝素125μ/(kg.d)]42例、血栓通组[泼尼松+血栓通10 mg/(kg.d)]43例、联合治疗组[泼尼松+肝素125 u/(kg.d)+血栓通10 mg/(kg.d)]43例,总疗程4周.所有患儿在治疗前及治疗3周时行24 h尿蛋白定量、血Alb、Chol、TG、BUN、Scr及凝血功能(PT、APTT、Fg、D2聚体)等检查,并记录不良反应情况.结果联合治疗组患儿完全缓解率为81.40%,肝素组为66.67%,血栓通组为53.49%.联合治疗组完全缓解率明显高于肝素组及血栓通组(P<0.05);各组患儿治疗前后比较,24 h尿蛋白定量、胆固醇、甘油三酯、Fg及D2-聚体均明显下降(P<0.05),血浆白蛋白明显升高(P<0.05);联合治疗组尿蛋白定量下降程度及血浆白蛋白升高程度均明显高于肝素组及血栓通组(P<0.05);联合治疗组和血栓通组胆固醇、甘油三酯下降程度明显高于肝素组(P<0.05),而联合治疗组和血栓通组之间差异无统计学意义(P>0.05);联合治疗组Fg及D2-聚体较血栓通组及肝素组下降更明显(P<0.05).结论血栓通联合肝素治疗可更有效改善肾病综合症患儿的高凝状态及高脂血症.Objective To observe the efficacy of Panax notognsens(PNS)combined with heparin in the treatment of hypercoagulable status and hperlipidemia in children with nephrotic syndrome.Methods 128 in-patient nephrotic syndrome children with hypercoagulable and hperlipidemia were selected and were treated with full Dosage Prednisonum[2 mg/(kg.d),maximal dose 60 mg/d]and were randomly divided into 3 groups:heparin group[Prednisonum+heparin 125 u/(kg.d),n=42],PNS group[Prednisonum+PNS 10 mg/(kg.d),n=43]and therapeutic alliance group[Prednisonum+heparin 125 μ/(kg.d)+PNS 10 mg/(kg.d),n=43].The treatment lasted for 4 weeks.24 hours urine protein,blood Alb,Chol,TG,BUN,Scr and blood clotting function(PT,APTT,Fg,DD)were detected before and after 3 weeks of treatment.Results The complete remission rate of therapeutic alliance group was 81.40%,which was significantly higher than that of heparin group and PNS group(P<0.05).24 hours urine protein,blood Chol,TG and blood Fg,DD were significantly decreased and blood Alb was significantly increased after treatment than before(P<0.05).The changing of 24 hours urine protein and blood Alb of therapeutic alliance group was significantly different compared heparin group and PNS group(P<0.05).The blood Chol and TG of therapeutic alliance group and PNS group were significantly decreased than that of heparin group(P<0.05).The blood Fg and DD of therapeutic alliance group was significantly decreased than that of heparin group and PNS group(P<0.05).Conclusion PHS combined with heparin has better effect in the treatment of children with nephritic syndrome complicating with hypercoagulable status and hyperlipidemia.

关 键 词：小儿 肾病综合征 血栓通 高凝状态 高脂血症 

分 类 号：R272[医药卫生—中医儿科学]