低分子右旋糖酐、速尿与肝素钠配伍对儿童肾病综合征患者利尿作用与高凝状态的影响

Effect of low-molecular weight dextran/furosemide plus sodium heparin on diuresis and hypercoagulability in childhood nephritic syndrome

目的:探讨低分子右旋糖酐、速尿与肝素钠配伍对儿童肾病综合征(NS)利尿作用与高凝状态的影响。方法:对45例新入院的住院NS患儿使用低分子右旋糖酐、速尿与肝素钠配伍治疗,观察其治疗前后的尿量、体重,并测定其治疗前后血流变学指标,血小板聚集功能、纤溶活性等指标并与25例采用潘生丁、激素治疗者进行对照观察。结果:观察组患儿治疗后较治疗前尿量明显增加,体重明显下降(P<0.01),治疗后观察组的尿量、体重与对照组比较也有显著性差异(P<0.05)。观察组血浆黏度、全血黏度(高切、低切)、血栓形成系数、血小板聚集治疗后较治疗前明显好转(P<0.01);对照组治疗前后这些指标无显著性差异(P>0.05);治疗后观察组与对照组比较有显著性差异(P<0.05)。组织纤溶酶原激活物(t-PA):纤溶酶原活化剂抑制物(PAI)、血浆α2抗纤溶酶(α2-AP)治疗前后无显著性差异,与对照组相比无显著性差异(P>0.05)。结论:采用低分子右旋糖酐和速尿、肝素钠联合治疗儿童NS水肿,既可达到利尿消肿的目的,又有抗凝、降低高凝状态的作用。

Objective：To observe the effect of low-molecular weight dextran/furosemide plus Sodium Heparin on diuresis and hypercoagulability in Pimary nephrotic syndrome （PNS）. Methods： Forty patients with PNS were treated with low-molecular weight dextran/furosemide plus sodium heparin in addition to conventional therapy, and their 24-hour urine volume, body weight, hemorheology, platelet aggregation and fibrinolytic indexes Lt-PA, PAl and x2-AP） were determined. Control group accepted conventional therapy. Results： There were obvious increase of 24-hour urine volume and significant decrease of body weight in control （P〈0. 05） and treatment group （P〈0. 01） after therapy. Hemorheology and platelet aggregation showed dramatic improvement in treatment group （P〈0.01） but not in control group （P〉0.05） after therapy. There were no statistical difference in fibrolytic indexes between two groups （P〉0. 05）. Conclusion： Combined therapy of low-molecular weight dextran/furosemide plus sodium heparin in PNS not noly has diuretic action, but also has anticoagulant effect.