低分子肝素钠和右旋糖酐对肾病综合征高凝状态治疗效果的影响研究

Effect of low molecular weight heparin sodium and dextran on treatment of hypercoagulable state in nephrotic syndrome

目的探讨低分子肝素钠和右旋糖酐对肾病综合征高凝状态治疗效果的影响。方法选择2015年1月~2017年10月120例肾病综合征高凝状态患者,运用随机数字表法将其分为对照组(n=60)与实验组(n=60),对照组施以常规的抗凝治疗方法,实验组施以低分子肝素钠联合右旋糖酐治疗方法,观察两组患者的血小板计数、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、临床治疗效果与治疗前后的血清ALB、血清TP、24h尿蛋白(24hU-PRO)、尿素氮(BUN)、肌酐(Cr)指标的水平变化情况及不良反应发生情况。结果治疗前,两组患者的血清ALB、血清TP、24h尿蛋白(U-PRO)、尿素氮(BUN)、肌酐(Cr)等指标无显著差异,并且血小板计数、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)无显著变化,无统计学意义(P>0.05);治疗后,实验组患者的血小板计数、24hU-PRO、Cr、BUN等指标含量明显低于对照组,其血清ALB、血清TP含量明显高于对照组,其APTT与PT明显长于对照组,其临床总治愈率明显高于对照组,其不良反应总发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论低分子肝素钠联合右旋糖酐对肾病综合征高凝状态治疗具有显著效果,不仅能够有效的改善患者的疾病状况,同时能够有效的提升患者的临床治疗治疗总有效率,对患者具有重要作用,同时具有较高的临床推广价值。

Objective To investigate the effect of low molecular weight heparin sodium and dextran on treatment of hypercoagulable state in nephrotic syndrome. Methods From January 2015 to October 2017, 120 patients with hypercoagulable state in nephrotic syndrome were selected and divided into control group（n=60） and experimental group（n=60） according to random number table method. The control group was given conventional anticoagulant therapy, experimental group was given low molecular weight heparin combined dextran treatment. The platelet count, prothrombin time（PT）, partial prothrombin time（APTT）, clinical therapeutic effect and serum ALB, serum TP, 24hU-PRO and urea nitrogen（BUN）, creatinine（Cr） indicators of the level of changes and adverse reactions of two groups were observed. Results Before treatment, there were no significant differences in serum ALB, serum TP, 24hU-PRO, BUN and Cr between the two groups, and there was no significant difference in platelet count, PT and APTT levels （P 〉0.05）. After treatment, the platelet count, 24hU-PRO, Cr, BUN and other indexes in the experimental group were significantly lower than those in the control Group, the serum ALB, serum TP levels were significantly higher than those of control group, the APTT and PT were significantly longer than those of control group, the clinical total cure rate was significantly higher than that of control group, the overall incidence of adverse reactions was significantly lower than that of control group, the difference was statistically significance（P 〈0.05）. Conclusion Low molecular weight heparin combined with dextran has a significant effect on the treatment of hypercoagulable state in nephrotic syndrome, which not only can effectively improve the patient＇s disease status, but also can effectively improve the total effective rate of clinical treatment of patients, which plays an important role in patients, and has high value of clinical promotion.