低分子肝素钙联合五水头孢唑林钠治疗儿童急性肾炎的效果观察

Observation on the efficacy of combination of Nadroparin Calcium with Cefazolin Sodium Pentahydrate in the treatment of children with acute nephritis

目的研究低分子肝素钙联合五水头孢唑林钠治疗儿童急性肾炎的效果。方法选取昆明市儿童医院肾内科2014年3月~2016年3月收治的急性肾炎患儿60例,采用随机数字表法将其分为对照组与观察组。两组患儿均卧床休息,适当限制水和盐的摄入,饮食以易消化、低盐、低蛋白为主。对照组给予五水头孢唑林钠50 mg/kg静脉滴注,1次/d,连续10 d为1个疗程。观察组在对照组治疗的基础上给予低分子肝素钙100 U/(kg·d),皮下注射,连续10 d为1个疗程。两组均观察1个疗程。比较两组尿白蛋白(Alb)、尿β2-微球蛋白(β2-MG)、血清D-二聚体(D-D)和血栓调节蛋白(TM)水平的变化情况,观察两组疗效及不良反应发生情况。结果观察组总有效率(93.4%)显著高于对照组(79.9%),差异有统计学意义(P<0.05)。治疗后,两组尿Alb、β2-MG、血清D-D和TM均较治疗前显著下降(P<0.05),且观察组下降更明显,差异有统计学意义(P<0.05)。结论低分子肝素钙联合五水头孢唑林钠治疗儿童急性肾炎是安全有效的。

Objective To evaluate the efficacy of combination of Nadroparin Calcium with Cefazolin Sodium Pentahydrate in the treatment of children with acute nephritis. Methods From March 2014 to March 2016, 60 cases of children with acute nephritis admitted to Department of Nephrology, Kunming Children＇s Hospital were selected and randomly divided into observation group and control group by random number table. Both groups were stay in bed, the children were limited the intake of water and salt properly, the main diet was those easy to be digested, low salt, low protein. The control group were treated with Cefazolin Sodium Pentahydrate 50 mg/kg, intravenously, once a day, 10 days was as a course. On the basis of the treatment of control group, the observation group was injected with Nadroparin Calcium subcutaneously 100 U/（kg·d）, 10 days was as a course. Both groups were observed for one course. The changes of levels of urine albumin （Alb）, urine β2-microglobumin （β2-MG）, serum D-Dimer （D-D）and thrombomodulin （TM） of the two groups were compared, the effects and the occurrence of adverse reactions of the two groups were observed. Results The effective rate of observation group （93.4%） was higher than that of control group （79.9%）, the difference was statis- tically significant （P 〈 0.05）. After treatment, the levels of urine Alb and β2-MG, serum D-D and TM in the two groups were all significantly lower than those before treatment （P 〈 0.05）, and the decrease in the observation group was more significant （P 〈 0.05）. Conclusion The combination of Nadroparin Calcium with Cefazolin Sodium Pentahydrate in the treatment of children with acute nephritis is safe and effective.