低分子肝素钙联合羟苯磺酸钙治疗糖尿病肾病的临床观察

Low Molecular Weight Heparin and calcium dobesilate treatment of diabetic nephropathy

目的：观察低分子肝素钙联合羟笨磺酸钙治疗糖尿病肾病的临床疗效。方法：36例糖尿病肾病患者随机分为对照组（18例）和低分子肝素钙联舍羟苯磺酸钙观察组（18例），观察纽在常规降糖，降脂，降压等基础上加用低分子肝素钙联合羟苯磺酸钙，疗程2w。观察治疗前后血液流变学、凝血功能、24h尿蛋白排泄量（UPE）、血清白蛋白（ALB）、血清总胆固醇（TC）及肾功能等指标变化。结果：与对照组相比，观察组UPE明显减少（P〈0．01），ALB明显增加而TC有所下降（P〈0．05）；血液流变学和凝血指标，如血粘度，血小板黏附率，血沉，血小板计数和纤雏蛋白原明显降低，活化部分凝血活酶时间明显延长，抗凝血酶明显升高（P〈0．05）；血清肌酐（Set），内生肌酐清除率（Ccr）两组间有显著性差异（P〈0．05），疗程中未见明显的不良反应。结论：低分子肝素钙联合羟苯磺酸钙可降低糖尿病肾病患者的尿蛋白和血清总胆固醇，提高血清白蛋白，改善血液流变学厦抗凝指标。

Objective： To observe the low molecular weight heparin calcium and calcium dobesilate treatment of diabetic nephropathy. Methods： 36 patients with diabetic nephropathy were randomly divided into control group （18 cases） and low molecular weight heparin calcium and calcium dnbesilate observation group （18 cases）, the treatment group also hypoglycemic, lipid--lowering, blood pressure, etc. Based on the increase low molecular weight heparin combined with calcium dobesilate, treatment 2 w. Before and after treatment blood rheolngy, coagulation, 24 h urinary protein excretion （UPE）, serum albumin （ALB）, serum total cholesterol （TC） and renal function were observed. Results： Compared with the control group, the observation group UPE decreased （P 〈0.01）, ALB TC increased significantly decreased （P 〈0.05） ; blood rheology and coagulation, such as blood viscosity, platelet adhesion rate, ESR, platelct count and significantly lower fibrinogen, activated partial thromboplastin time was prolonged, antithrombin significantly increased （P〈0.05） ; serum creatinine （Scr）, and creatinine clearance rate （Ccr） between the two groups significant differences （P〈0.05）, treatment in no significant adverse reactions. Conclusion： LMWH and calcium dobesilate in patients with diabetic nephropathy can reduce urinary protein and serum total cholesterol, increased serum albumin, to improve blood rheology and anticoagulation.