肝素钠预防紫癜性肾炎32例临床观察

Heparin Sodium Prevent Purpura form Nephritis'Olinical Observation The departrnent of Pediatrics of the third

目的 :观察肝素钠预防紫癜性肾炎的疗效。方法 :从 38例确诊为过敏性紫癜患儿中 ,选出 32例无肾病表现的作为观察对象。全部对象在一般治疗 (息斯敏、西米替丁、葡萄糖酸钙 )的同时加用肝素钠预防肾损害。肝素钠用法分两组 :小剂量组 12例 ,采用肝素钠 10 0 - 12 5u/kg·d静滴 ,每日一次 ;超微剂量组 2 0例 ,采用肝素钠 2 0 - 2 5u/kg·d ,分 2次皮下注射 ,均 7天为一疗程。治疗期间注意观察肝素钠的出血及其它副作用 ,定期检查尿液 ,随访时间≥ 2个月。如尿检中RBC≥ 5个 /HP ,尿分析RBC≥ 5 0 /ul和 /或尿蛋白阳性 ,则认为发生紫癜性肾炎。结果 :在 32例观察对象中 ,除 2例失访外 ,30例随访者中发生紫癜性肾炎仅 2例 ,发生率为 6 .7% ,明显低于文献报道的平均发生率 37.6 % (p <0 .0 1)。小剂量组及超微剂量组各发生 1例 ,发生率分别为 8.3% (1/12 )及5 .6 % (1/18) ,无显著差异。所有对象均未出现肝素副作用。结论 :肝素钠预防紫癜性肾炎安全有效。

s Aim:obserue the effects that heparin sqdium preuent purpura form nephritis.Method:Form thirty-eight confirmed diagnosis patients,thinty-two patients that behave anephrogenesis are selected to be obiects.All object received usual cure (astemi201e,cmetidine,calglucon) as well as add heparin sodium to prevent renal damage.The method of heparin sodium are divided into two Groups:Small dose group heparin sodium 100-125u/kg·d intravenous therapy once per day ultra micro-dose group,heparin sodium 20-25u/kb·d hypodermic inject twice per minute.Two groups all take a week as a course of treat ment During the time of cwre,ae must observe the bleeding of heparin sedium and other side offeets.At the beginning of cure,examine the urine regnlarwy.the tine of follow-up survey is two or more than two menths.if RBC≥5/HP in uroscopy,RBC≥50/ul in urinalysis or urinary proteinis Positive is considered as purpura form nephritis.In the result,two samples lose survey and in thirty patients of follow-up survey,there are two samples of purpura form nephritis.The rate is 6.7% and it is obviously be below the average rate 37.6%(P<0.01) that the books report.The small dose group oceurs a sampleand so does the wltranicro-dose group.The rates are respectivery8.3%(1/12)and 5.6%(1/18) and thene are no obvions differences.All the objeets don't occwr side effeets of heparin.Results:Hepdrin sodiurn preuenting purpura form nephritis is safe and effective.There are no obvious differenees of small dose group and ultranicro-dose group from the linited materials