低分子肝素钙治疗小儿过敏性紫癜及预防肾损害的疗效观察

JEfficacy of low molecular weight heparin therapy and prevention of kidney damage in children with Henoch-Schnlein purpura

目的探讨低分子肝素钙治疗小儿过敏性紫癜(HSP)和预防肾损害的临床疗效。方法选择94例HSP患儿,随机分为研究组与对照组(各47例),对照组采用常规治疗方法,研究组在常规治疗的基础上加用低分子肝素钠,观察两组主要症状持续时间,治疗前后尿白蛋白(Alb)和尿β2-微球蛋白(β2-MG)水平变化及肾炎的发生情况,并观察两组的不良反应。结果两组治疗前尿Alb和尿β2-MG水平无统计差异,治疗后均有所降低,研究组治疗后尿Alb和尿β2-MG水平显著低于对照组(P均<0.05)。研究组皮疹、消化道症状的持续时间均显著低于对照组,肾炎的发生率显著低于对照组(P均<0.05),两组均无严重不良反应发生。结论早期予以低分子肝素钙治疗可减少HSP的临床症状持续时间,并具有明显的肾脏保护作用,值得临床推广应用。

Objective To investigate the efficaey of low molecular weight heparin therapy and preveniion of kidney damage in children with Henoch - Schonlein puipura （HSP）. Methods 94 cases of HSP were collected and randomly divided into study group and the control group （47 cases each） . Conventional treatment methods were used in the control group and in study group, on the basis of conventional therapy. Low molecular weight heparin was used. The duration of the main symptoms were observed after treatment. Changes of urinary albumin （Alb） and urinary β2 - microglobulin （ β2 - MG） were detected. Nephritis incidence and the adverse reactions were observed in both groups. Results Before treatment, urinary Alb and urinary β2 -MG levels did not show statistical differences. However, they were decreased after treatment. In study group, urine Alb and urinary β2 - MG level after treatment were significantly lower than those of the control group（ P 〈0.05）. Skin rash and gastrointestinal symptoms duration in study group were significantly lower than those of the control group. The incidence of nephritis was significantly lower than the control group （ P 〈 0.05 ）. There were no serious adverse events in both groups. Conclusion Early treatment of low molecular weight heparin can reduce the duration of the clinical symptoms of HSP, which has a significant effect of protecting kidney, and is worthy of clinical application.