丹参制剂联合肝素及激素治疗对过敏性紫癜患儿肾功能、血清VEGF及EGF的影响

Effects of salvia miltiorrhiza preparation combined with heparin and hormone on renal function,serum VEGF and EGF in children with henoch schonlein purpura

目的研究丹参制剂联合肝素及激素治疗对过敏性紫癜患儿肾功能、血清血管内皮生长因子(VEGF)及尿表皮生长因子(EGF)的影响。方法选取90例过敏性紫癜患儿,分为对照组行肝素及激素治疗,研究组在对照组基础上予以丹参制剂治疗,两组各45例。对比两组肾损伤发生率、损伤时间和程度,以及观察肾损伤患儿治疗前后血清VEGF及尿EGF的水平。结果研究组肾损伤发生率(11.11%)低于对照组(31.11%),差异有统计学意义(P<0.05)。研究组肾损伤时间[(38.65±29.05)d]亦低于对照组[(51.76±28.05)d],差异有统计学意义(P<0.05)。对照组患儿轻度、中+重度肾损伤比率为21.43%(3/14)、78.57%(11/14),研究组患儿轻度、中+重度肾损伤比率为100.00%(5/5)、0.00%(0/5),研究组肾损伤程度低于对照组(P<0.05)。19例肾损伤患儿在末次随访(治疗后2周)时的血清VEGF及EGF水平均高于治疗前(P均<0.05)。结论丹参注射液联合肝素及激素的治疗形式能够缩短过敏性紫癜患儿肾损伤时间,有效减轻肾功能损伤。血清VEGF及尿EGF可能参与过敏性紫癜患儿肾损伤的形成过程,可作为早期过敏性紫癜出现肾损伤的检测指标。

Objective To study the effects of Salvia miltiorrhiza preparation combined with heparin and hormone on renal function,serum vascular endothelial growth factor and urine epidermal growth factor in children with henoch schonlein purpura. Methods 90 cases of henoch schonlein purpura were selected in our hospital and divided into the control group who received heparin and hormone therapy and the study group who underwent Salvia miltiorrhiza preparation on the basis of the control group,with 45 cases in each group. The renal injury,serum vascular endothelial growth factor and epidermal growth factor were compared between the two groups. Results The incidence rate of renal injury in the study group（ 11. 11%） was lower than that in the control group（ 31. 11%）（ P〈0. 05） and the time of renal injury [（ 38. 65 ± 29. 05） d] was lower than that in the control group [（ 51. 76 ± 28. 05） d]（ P〈0. 05）; the rate of mild,moderate to severe renal injury in the control group was 21.43%（ 3/14）,78. 57%（ 11/14）,and 100. 00%（ 5/5）,0. 00%（ 0/5） with significant differences; at the end of the follow-up（ after 2 weeks of treatment）,the levels of serum vascular endothelial growth factor and urine epidermal growth factors were higher than before treatment in 19 cases of renal injury（ P〈0. 05）. Conclusion The combined treatment of Salvia miltiorrhiza preparation,heparin and hormone can shorten the time of renal injury in children with henoch schonlein purpura,which can effectively reduce renal injury. The serum vascular endothelial growth factor and urine epidermal growth factor may participate in the formation process of renal injury in children with henoch schonlein purpura,which can be used for early detection of renal injury in Henoch Schonlein purpura.