低分子肝素钙注射液与泼尼松联合治疗用于小儿肾病综合征临床效果研究

Clinical effect of low molecular weight heparin calcium injection combined with prednisone in the treatment of nephrotic syndrome in children

目的 研究低分子肝素钙联合泼尼松治疗小儿肾病综合征的临床疗效。方法 本次研究对象为安阳市人民医院儿科2021年8月—2022年8月收治的肾病综合征患儿72例,依据治疗方式将患儿分成两组,其中对照组(n=35)使用泼尼松治疗,观察组(n=37)使用低分子肝素钙注射液与泼尼松联合治疗,比较两组临床疗效,重点观察两组凝血功能和肾功能。结果 观察组总有效率为94.59%,明显高于对照组(77.14%)(P<0.05);治疗前两组尿素氮(BUN)、血肌酐(Scr)、肌酐清除率(Ccr)及24 h尿蛋白定量水平比较差异无统计学意义(P>0.05),两组治疗后均明显降低,观察组BUN、Scr、Ccr及24 h尿蛋白定量水平分别为(7.02±0.53)mmol/L、(75.19±6.08)μmol/L、(65.10±4.69)mL/min及(0.87±0.21)g,均低于对照组(P<0.001);治疗前两组凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、抗凝血酶Ⅲ(AT-Ⅲ)及D-二聚体(D-D)水平比较无统计学意义(P>0.05),两组治疗后APTT、PT及AT-Ⅲ均明显升高,FIB及D-D降低,且观察组APTT、PT及AT-Ⅲ水平分别为(35.26±5.31)s、(18.26±3.07)s及(106.82±8.14)g/L,均高于对照组,FIB和D-D水平分别为(3.07±0.45)g/L和(0.34±0.09)mg/L,组间对比均P<0.001。结论 小儿肾病综合征治疗采用低分子肝素钙联合泼尼松可有效改善患儿凝血功能与肾功能,疗效好,具有推广价值。

Objective To study the clinical efficacy of low molecular weight heparin calcium combined with prednisone in the treatment of children with nephrotic syndrome. Methods The research object of 72 children with nephrotic syndrome admitted to Anyang people's Hospital from August 2021 to August 2022, were retrospectively analyzed, on the basis of treatment were divided into two groups, the control group(n=35) using prednisone treatment, the observation group(n=37) using low molecular heparin calcium injection and combination treatment with prednisone, the clinical efficacy of the two groups was compared, and the improvement of renal function and coagulation function of the two groups was observed. Results The total effective rate of the observation group was 94.59%, which was significantly higher than that of the control group(77.14%)(P<0.05). There was no significant difference in urea nitrogen(BUN), blood creatinine(Scr), creatinine clearance(Ccr) and 24 h urinary protein quantitative level between the two groups before treatment(P>0.05), and both groups were significantly reduced after treatment. BUN, Scr, Ccr and 24 h urinary protein quantitative levels in observation group were(7.02±0.53) mmol/L,(75.19±6.08) μmol/L,(65.10±4.69) mL/min and(0.87±0.21) g, respectively, which were lower than those of control group(P<0.001). Before treatment, there was no statistical significance in the levels of thromboplastin time(APTT), prothrombin time(PT), fibrinogen(FIB), antithrombin Ⅲ(AT-Ⅲ) and D-dimer(D-D) between the two groups(P>0.05). After treatment, APTT, PT and AT-Ⅲ were significantly increased, while FIB and D-D were decreased. The APTT, PT and AT-Ⅲ levels in the observation group were(35.26±5.31) s,(18.26±3.07) s and(106.82±8.14) g/L, respectively, which were higher than those in the control group, and the FIB and D-D levels were(3.07±0.45) g/L and(0.34±0.09) mg/L, respectively. All comparisons between groups were P<0.001.Conclusion Low molecular weight heparin calcium injection combined with prednisone has significant clinical efficacy in the treatment of children with nephrotic syndrome, which can effectively improve coagulation and renal function in children, and has the value of promotion.