舒洛地特对原发性肾病综合征高凝状态的影响  

Effects of sulodexide on hypercoagulable SHAO Feng-min. Department of Nephrology China state of nephrotic syndrome

作　　者：马旭[1] 朱清[1] 邵凤民[1] 

机构地区：[1]河南省人民医院肾内科,郑州450003

出　　处：《中国实用医刊》2013年第14期26-27,共2页Chinese Journal of Practical Medicine

摘　　要：目的观察舒洛地特对原发性肾病综合征患者凝血功能的影响，评价其在治疗肾病综合征高凝状态中的安全性。方法将28例肾病综合征患者随机分为两组，对照组在给予激素或（和）免疫抑制剂、钙片等常规治疗的基础上，给予低分子肝素4000U／d，皮下注射治疗，治疗组在给予激素或（和）免疫抑制剂、钙片等常规治疗的基础上，给予舒洛地特10mg／d，肌肉注射，疗程为2周，观察治疗前后患者尿量、24h尿蛋白、血清三酰白蛋白（ALB）、血清三酰甘油（TG）、总胆固醇（Ch01）以及凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）、D-二聚体（D-D）等变化。结果治疗2周后，两组患者尿量增加、体质量下降，ALB增加，TG和Chol明显下降，但两组间比较差异无统计学意义（P〉0．05）；与对照组相比，治疗组24h尿蛋白明显减少（P〈0．05）。和治疗前比较，两组主要凝血指标PT均无明显变化，APTT均延长、FIB和D—D均下降（P〈0．05），对照组变化更明显（P〈0．05）。结论舒洛地特和低分子肝素均可增加原发性肾病综合征患者尿量，降低尿蛋白、血脂，提高血清白蛋白，改善患者的高凝状态，舒乐地特相对更安全。Objective To investigate the effect of sulodexide on hypercoagulable state of nephrotic syndrome. Methods Twenty-eight patients of nephrotic syndrome were divided into two groups according to the different treatment protocols： the control group（ 14 cases）, which were given the regular therapy and subcutaneous low molecular weight heparin （4000 U, ih, qd） therapy; the treatment group （14 cases）, which were given regular therapy and the additional sulodexide（ 10 mg, iv, qd） therapy. The course of treatment were 2 weeks. Results The urinary protein decreased and albumin in plasma increased in both groups, cholesterol and triglycerides were lower, APTI＇ and TT prolonged, Fib level de- creased, there were significant differences between the two groups（ P 〈 0. 05 ）. Conclusions Sulodexide and low molecular weight heparin anticoagulation treatment of nephrotic syndrome can improve the hypercoagulable state and hemorheological disorders, sulodexide is safer than low molecular weight heparin.

关 键 词：舒洛地特 低分子肝素 原发性肾病综合征 

分 类 号：R692.3[医药卫生—泌尿科学]