低分子肝素治疗原发性肾病综合征高凝状态的临床观察  

Low-molecular weight heparin for treating primary nephrotic syndrome with hypercoagulable state

作　　者：王懿林[1] 马晓欣[1] 

机构地区：[1]山东省临沂市人民医院儿科,山东临沂276003

出　　处：《广东医学院学报》2003年第3期223-225,共3页Journal of Guangdong Medical College

摘　　要：目的 :了解低分子肝素对原发性肾病综合征伴高凝状态的治疗效果及其副作用。方法 :对 2 1例原发性肾病综合征伴高凝状态的患儿在激素治疗的同时加用低分子肝素 ,剂量为 60～ 10 0抗因子活性单位Xa/(kg .d) ,观察治疗前后 2 4h尿蛋白定量及凝血酶原时间、血浆纤维蛋白原、血纤维蛋白原降解产物、血D 二聚体的变化。另设 2 1例患儿作为对照组。结果 :治疗 8周时 ,治疗组较对照组 2 4h尿蛋白定量明显下降 (P <0 .0 5 )。 2周时 ,治疗组 19例血D 二聚体恢复正常 ,而对照组只有 12例恢复正常 ,(P <0 .0 5 ) ;治疗组 2 0例血纤维蛋白原降解产物恢复正常 ,而对照组只有 14例恢复正常 (P<0 .0 5 )。治疗组与对照组凝血酶原时间在治疗前后变化均不明显 (P >0 .0 5 )。治疗组与对照组血纤维蛋白原在治疗 1周时差异无显著性意义 (P >0 .0 5 ) ,2周时差异有显著性意义 (P <0 .0 5 )。结论 :低分子肝素可降低尿蛋白 ,抗凝效果较双嘧达莫好 。Objective:To observe the effect of low molecular weight heparin(LMWH) on primary nephrotic syndrome(PNS) with hypercoagulable state.Methods:Twenty one children with PNS with hypercoagulable state were treated with corticosteroid plus LMWH (60 100 AXa/kg·d),and their 24 hour urine protein,prothrombin time,plasma fibrinogen,fibrinogen degradation product(FDP) and D dimer contents were also determined.Control group( n =21) accepted the combination of corticosteroid and dipyridamole.Results:Compared with control group,24 hour urine protein in treatment group was remarkably decreased after 8 week course( P< 0.05).After 2 week course,plasma FDP,D dimer and fibrinogen were obviously lower in treatment group than those in control group ( P< 0.05),but there was no statistical difference in prothrombin time between two groups ( P> 0.05).Conclusion:The anticoagulant effect of LMWH is superior to that of dipyridamole.LMWH could be an effective anticoagulant for treating PNS with hypercoagulable state. [

关 键 词：低分子肝素 治疗 原发性肾病综合征 高凝状态 临床观察 

分 类 号：R692[医药卫生—泌尿科学]