低分子肝素钠联合醋酸泼尼松片治疗原发性肾病综合征患者的效果

Effects of low molecular weight heparin sodium combined with Prednisone acetate tablets in treatment of patients with primary nephrotic syndrome

目的:探讨低分子肝素钠联合醋酸泼尼松片治疗原发性肾病综合征(PNS)患者的效果。方法:回顾性分析2019年8月至2020年12月该院收治的92例PNS患者的临床资料,按照治疗方案不同分为对照组和观察组各46例。对照组采用醋酸泼尼松片治疗,观察组在对照组的基础上联合低分子肝素钠治疗,均治疗14 d。比较两组临床疗效、治疗前后肾功能指标[24 h尿蛋白定量(24 h-Up)、血肌酐(Scr)、血尿素氮(BUN)]水平、血清白蛋白(Alb)水平、炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-8]水平、凝血功能指标[D-二聚体(D-D)、纤维蛋白原(FIB)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)]水平,以及不良反应发生率。结果:观察组治疗总有效率为95.65%(44/46),高于对照组的71.74%(33/46),差异有统计学意义(P<0.05);治疗后,观察组血清Alb水平高于对照组,PT、APTT值长于对照组,24 h-Up、TNF-α、IL-6、IL-8、Scr、BUN、D-D及FIB水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:低分子肝素钠联合醋酸泼尼松片治疗PNS患者效果确切,可改善患者肾功能、凝血功能,降低炎性因子水平,安全可靠。

Objective:To explore effects of low molecular weight heparin sodium combined with prednisone acetate tablets in treatment of patients with primary nephrotic syndrome(PNS).Methods:The clinical data of 92 patients with PNS admitted to this hospital from August 2019 to December 2020 were retrospectively analyzed,and they were divided into control group and observation group according to different treatment plans,46 cases in each group.The control group was treated with Prednisone acetate tablets,while the observation group was treated with low molecular weight heparin sodium on the basis of that of the control group.Both groups were treated for 14 days.The clinical effects,the renal function index[24 h urine protein quantitative(24 h-Up),serum creatinine(Scr),blood urea nitrogen(BUN)]levels,the serum albumin(Alb)level,the inflammatory factor levels[tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-8],the coagulation function index levels[D-dimer(D-D),fibrin Prothrombin time(FIB),prothrombin time(PT),activated partial thromboplastin time(APTT)],and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the observation group was 95.65%(44/46),which was higher than the control group of 71.74%(33/46),and the difference was statistically significant(P<0.05).After the treatment,the level of serum Alb in the observation group was higher than that in the control group;the PT and APTT were longer than those in the control group;the 24 h-Up,TNF-α,IL-6,IL-8,Scr,BUN,D-D and FIB levels were lower than those in the control group;and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Low molecular weight heparin sodium combined with Prednisone acetate tablets in the treatment of the patients with PNS is effective and can improve the renal function,the coagulation function and reduce the levels of inflammatory factors.Moreover,it is safe and reliable.