低分子肝素治疗肾病综合征的临床研究

The Study of low Molecular Weight Heparin in the Treatment of Nephrotic Syndrome

目的 :研究低分子肝素治疗肾病综合征能否促进病情的恢复和提高治疗效果。方法 :采用随机对照分组 ,治疗组 (n =2 4)应用低分子肝素联合激素 ,对照组 (n =2 8)应用常规激素疗法 ,观察两组临床疗效 ,尿量增多和2 4h尿蛋白减少所需时间 ,血肌酐 (Cr)水平、血清白蛋白 (ALB)水平、血纤维蛋白原 (FIB)水平和血胆固醇 (TCH)水平的变化。结果 :治疗组总有效率为 91 7% ,对照组 6 7 8% (P <0 0 5 )。治疗组较对照组 2 4h尿量开始增加的时间早 (P <0 0 5 )、2 4h尿蛋白出现减少的时间早 (P <0 0 5 )、血Cr下降程度大 (<0 0 5 )、血清白蛋白上升幅度大(P <0 0 5 )、FIB下降程度大 (P <0 0 5 ) ,与对照组比差异有显著性。TCH两组均有下降 ,但差异无显著性 (P >0 0 5 )。结论

Objective:To study the clinical efficacy of low molecular weight heparin in the treatment of nephrotic syndrome. Methods: Patients were randomly divided into 2 groups. The treatment group (n=24) was treated with LMWH and prednison,while the control group (n=28) was treated with prednison alone. The clinical efficacy,the time needed to increase the urine volume and to reduce the urine protein of 24 hours,the changes of the creatinine,levels of albumin,fibrinogen and total cholesterol (TCH) in blood were compared between two groups. Results: The total effective rate in the treatment group and control group were 91.7% and 67.8% respectively ( P <0.05). Compared with the control group,the urine volume increased ( P <0.05)and the 24 huors' urine protein decreased more quickly ( P <0.05). The falling of the levels of blood creatinine and fibrinogen and the elevation of the serum albumin were remarkably greater in the treatment group ( P <0.05). TCH dropped in both groups without significant difference ( P <0.05). Conclusion: LMWH enhances the efficacy of the routine prednison therapy in the treatment of neprotic syndrome.