低分子肝素钠治疗过敏性紫癜肾炎疗效分析

Analysis of effectivity of low molecular heparin sodium in treatment of Schonlein-Henoch purpura nephritis

目的:观察低分子肝素钠治疗过敏性紫癜肾炎的疗效和安全性。方法:将45例过敏性紫癜肾炎患者分为低分子肝素钠治疗组(23例)和对照组(22例)。对照组给予常规治疗:口服血管紧张素转换酶抑制剂(ACEI)或血管紧张素Ⅱ受体拮抗剂(ARB),强的松0.6～0.8 mg/(kg·d),静脉注射环磷酰胺(CTX)0.75 g/m^2,或口服雷公藤多甙片2 mg/(kg·d),并配合其他综合治疗。治疗组除常规治疗外,皮下注射低分子肝素钠100IU/(kg·d),疗程2～4周。观察尿红细胞及尿蛋白、皮疹复发、低分子肝素钠不良反应;长期随访观察疾病转归。结果:治疗组2、6、8周时尿红细胞及尿蛋白明显少于对照组(P<005或P<001),治疗组皮肤紫癜及血尿蛋白尿复发率明显低于对照组(P<005或P<001);使用低分子肝素钠未见严重不良反应。长期随访两组肾脏临床表现与预后关系比较差异无显著。结论:低分子肝素钠治疗过敏性紫癜肾炎,可明显减少血尿和蛋白尿,使用低分子肝素钠安全可靠。

Objective：To observe the effectivity and safety of low molecular heparin sodium in the treatment of Schonlein-Henoch purpura nephritis.Methods：Forty-five cases of Schonlein-Henoch purpura nephritis were divided into 2 groups：low molecular heparin sodium treatment group （23 cases） and control group （22 cases）.The control group received routine treatment： oral angiotensin converting enzyme inhibitors （ACEI） or angiotensin II receptor antagonists （ARB）, prednisone 0.6-0.8 mg/（kg· d）,intravenous injection of cyclophosphamide（CTX） 0.75 g/m^2, or oral tripterygium wilfordii 2 mg/（kg.d）, And to cooperate with other comprehensive treatment.In addition to the routine treatment, treatment group received low molect, lar heparin sodium in the dose of 100 IU/kg.d for 2-4 weeks.To observe urine red blood cell,urine protine,relapse of rash and adverse reaction conditions of low molecular heparin sodium;to follow-up disease prognosis of long-term.Results ：Significant decreases of urine red blood cell, urine protien, and significant decreased relapse rate of skin purpura, hematuria and proteinuria in low molecular heparin sodium treated group were observed when compared with those in control group,no serious adverse reactions happened using low molecular heparin sodium.In long-term follow-up of two groups, kidney clinical manifestations and prognosis had no significant differences.Conclusion：Low molecular heparin sodium is safe and has better effect on decreasing hematuria and proteinuria.