来氟米特联合银杏达莫对肾病综合征患者高凝状态的影响及疗效观察  

Observation of the influence and curative effect of leflunomide combined with ginkgo leaf extract and dipyridamole on hypercoagulable state in patients with nephrotic syndrome

作　　者：吴胜本[1] 马锐 

机构地区：[1]山东省滨州市人民医院门诊药房,256600 [2]山东省滨州市中医医院药剂科

出　　处：《中国医师进修杂志》2014年第4期29-32,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨来氟米特联合银杏达莫对肾病综合征患者高凝状态的影响及治疗效果.方法 收集95例首次诊治的肾病综合征患者,按随机数字表法分为试验组50例,给予来氟米特联合银杏达莫治疗;对照组45例,给予来氟米特治疗.治疗前后分别检测两组凝血功能和肾功能指标.结果 治疗后,试验组血小板激活复合物-1的表达水平从（7.33±1.69）％下降到（2.58±0.97）％,CD62p的表达水平从（6.15±1.59）％下降到（3.18±1.03）％,均明显低于对照组治疗后的（7.23±1.41）％和（5.99±1.51）％,差异有统计学意义（P＜0.05）.试验组凝血酶原时间从（10.62±0.45）s延长至（12.88±0.69）s,活化部分凝血活酶时间从（23.33±2.79）s延长至（30.57±3.88）s,均明显高于对照组治疗后的（11.21±0.48）s和（23.46±2.79）s,差异有统计学意义（P＜0.05）;试验组血浆D-二聚体从（2.58±1.23） mg/L下降至（0.89±1.12） mg/L,纤维蛋白原从（3.68±1.21）g/L下降至（1.89±0.74）g/L,均明显低于对照组治疗后的（2.33±1.22） mg/L和（3.25±1.33） g/L,差异有统计学意义（P＜0.05）.两组治疗后血肌酐、尿素氮和24h尿蛋白含量均较治疗前明显降低,且试验组治疗后血肌酐及24h尿蛋白含量明显低于对照组[（85.38±18.56）μmol/L比（115.23±20.88） μmol/L、（1.07±0.38）g比（2.57±0.99）g],差异有统计学意义（P＜0.05）.结论 应用来氟米特联合银杏达莫治疗肾病综合征患者,不仅有效地缓解了高凝状态,而且肾功能也得到了更好地改善.Objective To explore the influence and curative effect of leflunomide combined with ginkgo leaf extract and dipyridamole on hypercoagulable state in patients with nephrotic syndrome.Methods Ninety-five patients who were the first diagnosed nephrotic syndrome were divided into experiment group （50 cases） and control group （45 cases） by random digits table method.The patients in experiment group were treated with leflunomide combined with ginkgo leaf extract and dipyridamole,while the patients in control group were treated with leflunomide.The coagulation function and renal function indexes were respectively detected before and after treatment.Results After treatment,the expression level of platelet activation complexes （PAC）-1 in experiment group decreased from （7.33 ± 1.69）％ to （2.58 ±0.97）％,and the expression level of CD62p decreased from （6.15 ± 1.59）％ to （3.18 ± 1.03）％,which were significantly lower than those after treatment in control group [（7.23 ± 1.41）％ and （5.99 ± 1.51）％],and there were statistical differences （P ＜ 0.05）.The prothrombin time in experiment group extended from （10.62 ±0.45） s to （12.88 ± 0.69） s,and the activated partial thromboplastin time extended from （23.33 ± 2.79） s to （30.57 ±3.88） s,which were significantly longer than those after treatment in control group [（11.21 ±0.48） s and （23.46 ± 2.79） s],and there were statistical differences （P ＜ 0.05）.The plasma D-dimer in experiment group decreased from （2.58 ± 1.23） mg/L to （0.89 ± 1.12） mg/L,the plasma fibrinogen decreased from （3.68 ± 1.21） g/L to （1.89 ± 0.74） g/L,which were significantly lower than those after treatment in control group [（2.33 ± 1.22） mg/L and （3.25 ± 1.33） g/L],and there were statistical differences （P＜0.05）.The serum creatinine,blood urea nitrogen and 24 h urine protein levels after treatment in the 2 groups were significantly lower than those before treatment,but the serum creatinine

关 键 词：肾病综合征 高凝状态 来氟米特 银杏达莫 

分 类 号：R692.3[医药卫生—泌尿科学]