川芎嗪对原发性肾病综合征患儿血浆TXB_2及6-Keto-PGF_(1α)影响的探讨

Influence of tetramethylpyrazine on plasma levels of TXB_2 and 6-Keto-PGF_(1α) in children with primary nephrotic syndrome

目的 :观察川芎嗪对小儿原发性肾病综合征 (NS)TXB2 、6 -Keto -PGF1α 变化的影响。方法 :将 30例小儿NS随机分为川芎嗪治疗组和常规治疗组各 15例。常规治疗组给予强的松治疗 4周 ,而川芎嗪治疗组在强的松治疗基础上加川芎嗪治疗 4周 ,观察两组尿蛋白转阴和水肿消退时间 ,测定两组治疗前后血浆血栓素B2 (TXB2 )、6 -酮 -前列腺素F1α(6 -Keto -PGF1α) ,纤维蛋白原和血小板聚集率。结果 :川芎嗪治疗组血浆TXB2 治疗后有明显减低、血浆 6 -Keto -PGF1α治疗后有明显升高 ,较常规治疗组治疗后TXB2 下降及 6 -Keto -PGF1α升高程度更大 (P <0 0 1) ;川芎嗪治疗组治疗后纤维蛋白原、血小板聚集率明显降低 ,而常规治疗组治疗后两者无变化 ;川芎嗪治疗组治疗后尿蛋白转阴和水肿消退时间明显快于常规治疗组 (P <0 0 1)。结论 :川芎嗪能抑制NS病人TXA2 的产生 ,促进PGI2 生成 ,从而纠正TXA2 -PGI2 失衡 ,同时改善血液高凝状态 ,近期疗效优于常规治疗组。

Objective:To study the influence of tetramethylpyrazine(TMPZ)on plasma levels of TXB 2 and 6-Keto-PGF 1α in children with primary nephrotic syndrome.Methods:30 cases were randomly assigned to the prednisone-treated group (n=15) and the TM PZ treated group(n=15),20 healthy children were served as normal control.In the prednisone-treated group,prednisone was administered orally for 4 weeks.In the TMPZ-treated group,TMPZ was administered intravenously for 4 weeks,along with prednisone.The days when proteinuria and edema clearing were observed,plasma levels of TXB 2,6-Keto-PGF 1α,fibrinogen and platelet aggregation ratio were measured in the pre-or post-treatment.Results: The levels of TXB 2 were significantly lower in the post-treatment plasma than in the pre treatment plasma with TMPZ(P<0.01).The levels of 6-Keto-PGF 1αwere significantly higher in the post-treatment plasma than in the pre-treatment plasma with TMPZ(P<0.01).The decrease in TXB 2 levels and increase in 6-Keto-PGF 1α levels could be observed in the post-treatment specimens between the prednisone-treated group and the TMPZ-treated group,and much more evidently in the TMPZ-treated group(P<0.01).The fibrinogen levels and platelet aggregation ratio were markedly lower in the post-treatment plasma than in the pre-treatment plasma with TMPZ.In the prednisone-treated group,the fibrinogen levels and platelet aggregation ratio were not significantly different between the pre-treatment and the post-treatment specimens (P>0.05).The days when proteinuria and edema clearing were markedly shorter in the post-treatment with TMPZ than in the post-treatment with prednisone(P<0.01).Conclusion: TMPZ could reduce the production of TXA 2 and increase the production of PGI 2 in children with nephrotic syndrome so that TXA 2-PGI 2 imbalance and hypercoagulable state was improved. The short-term therapeutical effects were markedly better in the TMPZ-treated group than in the prednisone-treated group.