小剂量肝素钙治疗小儿原发性肾病综合征疗效评价  

Therapeutic Effect of Low-Dose Hepacarin in the Childhood Primary Nephrotic Syndrome

作　　者：吴小川[1] 易著文[1] 党西强[1] 何庆南[1] 黄丹琳[1] 

机构地区：[1]中南大学湘雅二医院小儿肾脏病研究室,湖南长沙410011

出　　处：《中国当代儿科杂志》2002年第3期177-179,共3页Chinese Journal of Contemporary Pediatrics

摘　　要：目的　探讨小剂量肝素钙在小儿原发性肾病综合征中的治疗作用。方法　对 82例原发性肾病综合征合并高凝状态的患儿进行前瞻性研究 ,所有患儿均常规服用泼尼松每日 2mg/kg (最大量 <6 0mg/d) ,其中 5 2例患儿为肝素钙治疗组 (每日 5 0IU/kg ,静脉点滴 4周 ) ,另外 30例为对照组。 结果　治疗组尿蛋白转阴率与对照组差异无显著性 (P >0 .0 5 )。尿蛋白转阴病例中 ,治疗组尿蛋白转阴时间明显短于对照组 [(13.0 8± 4 .75 )dvs(19.33± 4 .4 8)d](P <0 .0 1) ,开始利尿时间亦明显少于对照组 [(9.6 4± 2 .6 5 )dvs (17.0 7± 3.99)d](P <0 .0 1)。治疗组血纤维蛋白原恢复正常率明显高于对照组 (93.3%vs 6 5 .4 % ) (P <0 .0 5 )。治疗组尿FDP恢复正常率与对照组差异无显著性 (P >0 .0 5 )。结论　小剂量肝素钙不能提高原发性肾病综合征患儿尿蛋白转阴率 ,但可缩短诱导缓解时间 ,增强利尿效果 。Objective To investigate the effect of low-dose hepacarin in the treatment of the primary nephrotic syndrome in children. Methods Eighty two children with the primary nephrotic syndrome in the hypercoagulable state were studied prospectively. All the patients were administrated with prednisone 2 mg/kg·d (maximum dose ≤ 60 mg/d). Fifty two of them, besides prednisone, were administrated with hepacarin (50 IU/kg·d, intravenous injection for 4 weeks), who formed the treatment group. The other 30 belonged to the control group. Results There was no significant difference in remission (negative proteinuria) between the treatment group and the control group (P> 0.05 ). The time taken for remission was shorter in the treatment group [( 13.08 ± 4.75 ) d] than that in the control group [( 19.33 ± 4.48 ) d] (P< 0.01 ), so was the initial diuresis time [( 9.64 ± 2.65 ) d vs ( 17.07 ± 3.99 ) d](P< 0.01 ). The plasma fibrinogen recovery efficiency in the treatment group ( 93.3% ) was significantly higher than that in the control group ( 65.4% ) (P< 0.05 ). However, no significant difference in the urinary FDP recovery efficiency was found between the two groups. Conclusions Low dose hepacarin had an obvious anticoagulation effect. Although it can not improve the remission rate of urinary protein in the treatment of the primary nephrotic syndrome in children, it can shorten the induced remission time and enhance diuresis effects.

关 键 词：治疗 原发性肾病综合征 疗效 病例分析 肝素钙 儿童 

分 类 号：R726.9[医药卫生—儿科]