小剂量尿激酶对IgA肾病患者肾功能及凝血功能的影响

Effect of low-dose urokinase on renal function and coagulation function in patients with IgA nephropathy

目的探究小剂量尿激酶对IgA肾病患者肾功能及凝血功能的影响。方法选择2017年3月至2018年2月我院收治的68例IgA肾病患者为研究对象,以随机数表法将其分为对照组与研究组,每组34例。患者均给予泼尼松、福辛普利常规治疗,在此基础上,对照组给予低分子量肝素钙,研究组给予小剂量尿激酶治疗。比较两组患者治疗前、后的肾功能、凝血功能及血栓形成率。结果治疗后,两组患者的血清BUN、SCr水平及24 h尿蛋白定量均降低,且研究组上述指标均优于对照组(P<0.05);治疗后,两组患者的D-二聚体、FIB水平均显著降低(P<0.05),但组间差异不显著(P>0.05);治疗期间,两组患者的血栓形成率比较,差异不显著(P=0.314)。结论对IgA肾病患者给予小剂量尿激酶治疗,不仅能够改善患者的纤溶活性,降低并发血栓形成的风险,同时还可改善机体肾脏功能,加强肾脏毒素的清除能力,利于延缓病情发展。

Objective To investigate the effect of low-dose urokinase on renal function and coagulation function inpatients with IgA nephropathy. Methods From March 2017 to February 2018, 68 cases of patients with IgA nephropathy inour hospital were divided into control group and study group, with 34 cases in each group. All patients were treated withconventional treatment of prednisone and fosinopril, on this basis, the control group was treated with low molecular weightheparin calcium, and the study group was treated with low-dose urokinase. The renal function, coagulation function beforeand after treatment and thrombosis rates between the two groups were compared. Results After treatment, the levels ofserum BUN, SCr and 24h urine protein quantitation in the two groups significantly decreased, and those in the study groupwere better than the control group （P〈0.05）. After treatment, the levels of D-dimer and FIB in the two groups significantlydecreased（P〈0.05）, and those between the two groups were not significantly different（P〉0.05）. There was not significantlydifferent in the thrombosis rates during treatment between the two groups （P=0.314）. Conclusion Low-dose urokinase inpatients with IgA nephropathy can not only improve fibrinolytic activity and decrease the risk of thrombosis, but alsoimproves renal function, strengthen the clearance function of kidney toxins, it is conducive to delay the progression of thedisease.