Abstract
Objective:To investigate the fesibility of low molecular weight heparin combined with glucocorticoid therapy for children with primary nephrotic syndrome.Methods:A tatol of 110 children with primary nephrotic syndrome from January 2011 to January 2014 in our hospital were selected as the observed object,all children were randomly divided into observation group and control group,55 cases in each group.The control group received prednisone 1.5 to 2.0 mg/(kg · d) and symptomatic treatment for 4 weeks,within a maximum of 60.0 mg/d,the observation group received low molecular weight heparin 100 U/(kg · d) on the basis of the control group within a maximum of 5,000 U/d.The symptoms were observed before and after treatment,and laboratory indexes were detected,including APTF,PT,DD,FB,FB,urine volume,24 h Upro,Alb,Scr,TC,TG,et al,the clinical efficacy were evaluated,adverse events were recorded.Follow up for 10 months,recorded the number of children with recurring and the average immunoglobulin E (IgE) level after treatment for 3,6,9 months.Results:The FB,urine volume,Alb of the two groups after treatment were significantly higher than those before treatment (all P＜0.05),the DD,24 h Upro,TC were significantly lower than those before treatment (all P＜0.05).The FB,Urine,Alb of the observation group after treatment were significantly higher than those in the control group (all P＜0.05),the DD,24 h Upro,TC were significantly lower than those in the control group (all P＜0.05).The total effective rate of the observation group was 94.55％,the control group was 80.00％,the difference was statistically significant (x2 =12.952,P＜0.05).There were 1 case of children with subcutaneous petechiae and ecchymosis,1 case with nosebleed in observation group,and 2 case of children with subcutaneous petechiae and ecchymosis,1 case with nosebleed in control group,there were no significant differences in adverse reactions (P＞0.05).The number of disease recurrence in observation group were lower than control group,the difference was statistically significant (P＜0.05).After 3,6 and 9 months' treatment the average IgE levels of the observation group were lower than those of the control group,the differences were statistically significant (P＜0.05).Conclusion:The small doses of low molecular weight heparin can improve short-term efficacy,remit the hypercoagulable state of children,inhibit the formation of renal microcirculation of blood clots,improve renal microcirculation,reduce proteinuria excretion,delay or prevent the development of kidney disease process,no significant side effect,it is worthy of clinical use in the treatment of children with primary nephrotic syndrome.关键词
儿童/原发性肾病综合征/低分子肝素钠/抗凝Key words
children/primary nephrotic syndrome/low molecular weight heparin/anticoagulation分类
医药卫生
