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作 者:王娅敏 刘智美 苟玉竹 薛莲 WANG Yamin;LIU Zhimei;GOU Yuzhu;XUE Lian(Nephrology Deparrtment, West China Hospital, Sichuan University, Chengdu 610000, China)
机构地区:[1]四川大学华西医院肾内科,四川成都610000
出 处:《西部医学》2022年第2期211-215,共5页Medical Journal of West China
基 金:四川省科技厅应用基础研究项目(2018YJ0132)。
摘 要:目的探讨小剂量克赛联合百令胶囊对微小病变型肾病综合征(NS)患者高凝血状态和免疫功能的影响。方法选取2017年4月~2020年5月于本院就诊的90例微小病变型NS患者,按随机数表法分为观察组(45例)和对照组(45例)。对照组服用百令胶囊,观察组同时应用小剂量克赛。观察两组患者临床疗效、肾功能指标变化、凝血指标变化、血液流变学指标变化、T淋巴细胞亚群及药物不良反应。结果治疗后,观察组治疗总有效率高于对照组(P<0.05);观察组肾功能损伤指标及24 h尿蛋白水平均低于对照组(P<0.05);观察组凝血相关时间指标水平高于对照组,凝血相关因子水平低于对照组(P<0.05);观察组血液流变学指标水平低于对照组(P<0.05);观察组外周T淋巴细胞亚群检测结果显示CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组,CD8^(+)水平低于对照组(均P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论小剂量克赛联合百令胶囊对微小病变型肾病综合征患者疗效确切,可减少患者肾功能损伤,调节血液高凝状态,降低血液粘稠度,提升人体免疫功能,且安全性较好。Objective To study the effects of low-dose Clexane combined with Bailing capsules on hypercoagulability status and immune function of patients with Nephrotic syndrome(NS)with minor lesions.Methods A total of 90 NS with minor lesions patients who were treated in the hospital from April 2017 to May 2020 were enrolled and divided into observation group(45 cases)and control group(45 cases),according to random number table method.The control group was treated with Bailing capsules,while observation group was additionally treated with low-dose Clexane.The clinical curative effect,changes in renal function indexes,coagulation indexes and hemorheology indexes,T lymphocyte subsets and adverse drug reactions in both groups were observed.Results After treatment,the total response rate of treatment in observation group was higher than that in control group(95.56%vs 82.22%)(P<0.05).The indexes of renal function damage and level of 24h urine protein in observation group were lower than those in control group(P<0.05).The levels of coagulation-related time indexes in observation group were higher than those in control group,while levels of coagulation-related factors were lower than those in control group(P<0.05).The levels of hemorheology indexes in observation group were lower than those in control group(P<0.05).The test results about peripheral blood T lymphocyte subsets showed that levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in observation group were higher than those in control group,while CD8^(+)level was lower than that in control group(P<0.05).The difference in the incidence of adverse reactions between the two groups was not statistically significant(P>0.05).Conclusion The curative effect of low-dose Clexane combined with Bailing capsules is significant on NS with minor lesions patients.It can reduce renal function damage,regulate hypercoagulability status,reduce blood viscosity,and enhance immune function,with good safety.
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