小剂量低分子肝素防治过敏性紫癜肾损害的临床随机对照研究

Small doses of low molecular weight heparin prevention and treatment of Henoch-Schonlein purpura induced renal damage,randomized controlled clinical trial

目的:观察小剂量低分子肝素防治过敏性紫癜肾损害的临床有效性和安全性。方法:采用随即对照方法,将150例过敏性紫癜患儿分为治疗组(78例)和对照组(72例),两组患儿均给予常规治疗,治疗组在此基础上加用低分子肝素钠5-10U(/kg.d),加入0.9%氯化钠注射液100ml、1次/d静脉滴注,连用2周。用药期间查尿常规2次/周,治疗前后各查尿微量白蛋白、尿β2微球蛋白、凝血系列。治疗结束后,每月查尿常规、尿微量白蛋白、尿β2微球蛋白,随访6个月-12个月。结果:发生紫癜性肾损害的例数治疗组明显低于对照组,且在统计学处理上有显著差异性(P<0.05);治疗组中发生紫癜性肾损害者的损害程度明显低于对照组,且在统计学处理上有显著差异性(P<0.05);同时皮肤紫癜、消化道症状、关节症状消退时间比较差异有统计学意义(P<0.05),治疗组明显优于对照组;治疗总有效率比较,治疗组明显优于对照组(P<0.05)。结论:小剂量低分子肝素防治过敏性紫癜肾损害方法简单,用药安全,可避免常规剂量引发出血的副作用,无需监测凝血功能,且经济便宜。

Objective：Clinical observation of small dose low molecular weight heparin in prevention of Henoch-Schonlein purpura with renal impairment： clinical efficacy and safety. Methods： Using a randomized controlled method, 150 cases of allergic purpura were randomly divided into the treatment group （78 cases） and control group （72 cases）,two groups were given conventional treatment,the treatment group was based on combined with low molecular heparin sodium 5-10U/（kg o d）, adding 0.9% sodium chloride injection, 1 times / 100ml D intravenous infusion, for 2 weeks. During the treatment of urine routine 2 times/week, before and after each treatment urine albumin, urinary [32 microglobulin, coagulation series.After the endof treatment, a monthly check routine unne, urinary albumin, urinary 62 microglobulin, follow-up of 6 months -12 months. Results： Occurrence of Henoch-Schonlein purpura renal damage were significantly lower in treatment group than in control group, and there were significant differences in the statistical treatment of treatment group （P〈0.05）; in Henoch-Schonlein purpura renal damage damage degree was lower than the control group, and there were significant differences in the statistical treatment of （P〈0.05）; at the same time the skin purpura, digestive tract symptoms, joint symptoms subsided time had significant difference（P〈0.05）,the treatment group was significantly better than the control group; the total effective rate of treatment, the treatment group was better than the control group （P〈0.05）. Conclusion： Small dose low molecular weight heparin in prevention of Henoch-Schonlein purpura with renal involvement method is simple, safe, can avoid the conventional dose induced bleeding side effects, withoutthe need for coagulation monitoring, and cheap.