摘要
目的探讨不同剂量低分子肝素对过敏性紫癜性肾炎患儿血清胱抑素C(CysC)、基质金属蛋白酶9(MMP-9)与β2-微球蛋白(β2-MG)水平及凝血功能的影响。方法选择2015年11月至2017年4月甘肃省庆城县人民医院儿科收治住院的过敏性紫癜性肾炎患儿94例作为研究对象,随机分为小剂量低分子肝素组和大剂量低分子肝素组各47例。两组均给予基础治疗,在此基础上小剂量低分子肝素组皮下注射50~100U/(kg·d)低分子肝素钙治疗,大剂量低分子肝素组皮下注射150U/(kg·d)低分子肝素钙治疗。比较两组患儿临床疗效、血清CysC、MMP-9、β2-MG水平、炎性因子水平、凝血指标及不良反应发生情况。结果 (1)小剂量低分子肝素组临床总有效率为91.5%(43/47)与对照组的93.6%(44/47)比较差异无统计学意义(P>0.05)。(2)两组患儿治疗后血清CysC、MMP-9、β2-MG水平均显著低于同组治疗前,差异有统计学意义(P<0.05);两组治疗后血清CysC、MMP-9、β2-MG水平比较差异无统计学意义(P>0.05)。(3)两组患儿治疗后IL-4、IL-6及IL-8水平均显著低于同组治疗前,差异有统计学意义(P<0.05),两组治疗后各炎性指标水平比较差异无统计学意义(P>0.05)。(4)两组患儿治疗后凝血活酶时间、纤维蛋白原及D-二聚体检测值均显著低于同组治疗前,差异有统计学意义(P<0.05),凝血酶原时间检测值显著高于同组治疗前,差异有统计学意义(P<0.05)。治疗后两组各凝血指标检测值比较差异无统计学意义(P>0.05)。(5)小剂量低分子肝素组不良反应发生率为25.5%(12/47),显著低于大剂量低分子肝素组4.3%(2/47),差异有统计学意义(P<0.05)。结论过敏性紫癜性肾炎患儿临床使用不同剂量低分子肝素治疗均可取得理想的临床疗效,皮下注射小剂量低分子肝素安全性更高。
Objective To explore the effect of low molecular weight heparin in different doses on the levels of serum CysC, MMP-9 and β2-MG and the coagulation function in children with Henoch Schonlein purpura nephritis.MethodsTotally 94 children with Henoch Schonlein purpura nephritis treated in our hospital from November 2015 to April 2017 were selected, and were divided into group A (small dose) and group B(large dose) randomly, 47 cases in each group. Both groups were given basic treatment, and on the basis of that, group A were given subcutaneous injection of 50~100 U/(kg·d) low molecular heparin calcium, and group B were given subcutaneous injection of 150 U/(kg·d) low molecular heparin calcium. Clinical efficacy, the levels of serum CysC, MMP-9 and β2-MG, inflammatory factors, blood coagulation indexes and adverse reactions were compared between the two groups.ResultsTotal effective rate of group A was 93.62%(43/47), and there was no significant difference when compared with that of control group(95.74%,44/47)( P 〉0.05) . Serum CysC, MMP-9, and β2-MG levels were significantly lower than those before treatment in the two groups( P 〈0.05), but there was no significant difference between the two groups( P 〉 0.05). IL-4, IL-6 and IL-8 levels were significantly lower than those before treatment in the two groups( P 〈 0.05 ) , with little difference between the two groups( P 〉0.05). APTT, Fig and D-D levels were significantly lower than those before treatment in the two groups( P 〉0.05), and PT level was significantly higher than that before treatment, but there was no significant difference between the two groups( P 〉0.05). The incidence of adverse reactions in group A (25.5%,12/47) was significantly lower than that in group B (4.3% ,2/47)( P 〈0.05).Conclusion Satisfactory results can be achieved in treatment of children with Henoch Schonlein purpura nephritis with different doses of low molecular weight heparin, and subcutaneous injection of low molecular weight heparin is of higher safety.
作者
孙燕
任耀全
李冬梅
刘晓春
李莉
肖亚洲
SUN Yan;REN Yaoquan;LI Dongmei;LIU Xiaochun;LI Li;XIAO Yazhou(Department of Paediatrics,People's Hospital of Qingcheng County,Qingyang 745100,China)
出处
《中国中西医结合儿科学》
2018年第3期222-226,共5页
Chinese Pediatrics of Integrated Traditional and Western Medicine
关键词
过敏性紫癜性肾炎
低分子肝素
炎性因子
凝血功能
不良反应
儿童
Henoch Schonlein purpura nephritis
Low molecular weight heparin
Inflammatory factors
Coagulation function
Adverse reaction
Child