低分子肝素对原发性肾病综合征患者肾功能及血液流变学的影响

Effects of Low Molecular Weight Heparin on Renal Function and Hemorheology in Patients with Primary Nephrotic Syndrome

目的:探讨低分子肝素(LMWH)对原发性肾病综合征(PNS)患者肾功能及血液流变学的影响。方法:将48例PNS患者随机分成治疗组28例、对照组20例,观察2组治疗前、后24h尿蛋白定量、血浆白蛋白、血液流变学、尿素氮(BUN)、血肌酐(Cr)等指标的变化。结果:治疗组24h尿蛋白定量下降程度明显大于对照组(P<0.05),血浆白蛋白上升程度亦明显高于对照组(P<0.05),对血浆全血还原粘度、红细胞聚集指数、血浆粘度及高凝状态的改善作用显著优于对照组(P<0.05)。结论:LMWH治疗PNS患者可改善其血液高凝状态、增强激素和免疫抑制剂的临床疗效,缩短疗程,且安全性较好,值得临床推广。

OBJECTIVE： To investigate the effects of low molecular weight heparin （LMWH） on renal function and hemorheology in patients with primary nephrotic syndrome （PNS）. METHODS： A total of 48 PNS patients were enrolled,g8 were randomly assigned to receive LMWH （treatment group） and 20 to receive placebo （control group）. Changes in 24 hour urinary protein quantitation, plasma albumin, blood rheology, blood urea nitrogen （BUN） and blood creatitine （Cr） levels before and after treatment were observed. RESULTS： 24h- urinary protein had a greater reduction（P〈0.05） while plasma albumin had a greater increase（P〈0.05） in treatment group than in control group, and the treatment group showed a better improvement in plasma whole blood reduced viscosity, erythrocyte aggregation index, plasma viscosity and hypereoagulabale state （HCS） （P 〈 0.05） .CONCLUSIONS ： LMWH can be safely used to improve HCS, enhance the clinical efficacies of hormone and immunodepression while shorten the course of treatment in patients with PNS, and it deserves to be widely used in the clinic.