低分子肝素联合辛伐他汀对原发性肾病综合征高凝状态的作用

Effect of Low Molecular Heparin and Simvastatin on Hypercoagulabale State of Primary Nephrotic Syndrome

目的:研究小分子肝素联合辛伐他汀对原发性肾病综合征(PNS)的高凝状态的作用。方法:将128例PNS患者随机分为两组,对照组(64例)采用常规激素治疗,治疗组(64例)在常规激素的基础上加用小分子肝素和辛伐他汀。两组分别于治疗前和治疗后4周检测24h尿蛋白、血浆白蛋白、总胆固醇、甘油三酯、血液流变学及血凝指标,并观察有无出血并发症。结果:经4周治疗后,治疗组的完全缓解率(51.6%)和总有效率(90.6%)均明显高于对照组的完全缓解率(31.3%)和总有效率(73.4%),差异均具有统计学意义(P<0.05)。除APTT外,治疗组中24h尿蛋白和血脂显著降低,血浆白蛋白显著升高,血液流变学和其他血凝指标显著改善,血液粘度显著降低。除APTT外,治疗组中治疗后的其余各项指标均与对照组有显著差异(P<0.05),效果明显优于对照组(P<0.05)。两组中均未出现出血。结论:小分子肝素联合辛伐他汀可以更好的降低尿蛋白和血脂,纠正低蛋白血症,明显改善患者的高凝状态,降低血液粘度,显著提高了治疗效果。

Objective：To study the effect of low molecular heparin and simvastatin on hypercoagulabale state of primary nephrotic syndrome（PNS）.Methods：A total of 128 patients with PNS were randomly divided into two groups.Patients in control group（n=64） were given conventional therapy with prednisone.On the basis of therapeutic scheme in control group,the patients in treatment group（n=64） were treated with low molecular heparin and simvastatin.Twenty-four hour urinary protein,plasma albumin,total cholesterol,triglyceride,haemorheology,and targets of blood clotingting were tested in both groups before and 4 weeks after treatment.The complication of hemorrhage was observed.Results：Four weeks after treatment,the complete remission rate（51.6%） and total effective rate（90.6%） in treatment group were significantly higher than those（31.3% and 73.4%） in control group respectively（P0.05）.There were significant differences in all targets except APTT in treatment group between before and after treatment.Treatment group significantly excelled control group in decreasing twenty-four hour urinary protein,total cholesterol,triglyceride,blood viscosity,increasing plasma albumin and improving haemorheology except APTT（P0.05）.There was no hemorrhage in two groups.Conclusion：Treating PNS with low molecular heparin and simvastatin can significantly decrease urine protein and blood-fat,correct hypoproteinemia,improve hypercoagulabale state,and decrease blood viscosity.It notably enhance the therapeutic effect.