【摘要】 目的 :研究低分子肝素雾化吸入治疗小儿肾病综合征高凝状态的疗效及安全性。方法 :对 1 5例肾病综合征合并高凝状态患儿在激素或加用免疫抑制剂治疗的同时 ,加用低分子肝素雾化吸入 ,剂量为 2 0 0～ 30 0抗因子Xa活性单位 / (公斤·次 ) ,观察皮下瘀血、血小板、血D -二聚体、凝血酶原时间、部分凝血活酶时间及尿蛋白定量、血清白蛋白和胆固醇的变化。另设 1 5例患儿作为对照组。结果 :治疗组 1 4例血D -二聚体、凝血酶原时间、部分凝血活酶时间恢复正常 ,对照组 1 3例恢复正常 ,两组间的差异无统计学意义 (P >0 .0 5 ) ;治疗组无皮下瘀血、血小板减少现象 ,对照组 1 3例患儿出现皮下瘀血、2例患儿血小板减少。治疗前 ,治疗组的尿蛋白定量为 (5 .3± 3.2 ) g/2 4h ,血清白蛋白为 (1 3.3± 4 .1 ) g/L ,胆固醇为 (9.9± 2 .8)mmol/L ,治疗 4周后 ,三项指标分别为 (2 .3± 1 .5 ) g/ 2 4h ,(2 5 .3± 6 .3)g/L和 (7.9± 1 .4 )mmol/L ;治疗组血清白蛋白回升快于对照组 ,两组相比 ,差异有统计学意义 (P <0 .0 5 ) ;治疗 8周后 ,三项指标分别为 (0 .9± 0 .7) g/ 2 4h、(32 .6± 3.5 )g/L和 (5 .4± 0 .8)mmol/L ,两组相比差异无统计学意义 (P >0 .0 5 )。结论 :低分子肝素超声雾化吸入可改善小儿肾病综合征更多还原

【Abstract】 Objective:To investigate the effectiveness and safety of atomization inhalation of low-molecular heparin (LMH) in hypercoagulabale state (HCS) of child dropsical nephritis syndrome (CDNS).Methods:Atomization inhalation of LMH (200-300A X aIU/kilo.time) was prescribed to 15 children patients with CDNS combined with HCS after the treatment of hormone and immunosuppressive agent.Hypo-congestion,platelet (PLT),blood D-dimer,prothrombin time (PT),activated partial thromboplastin time (APTT),urine protein quantitation,albumin and cholesterol were investigated and compared with control group of 15 other child patients.Results:Blood D-dimer,PT,APTT recovered to normal in 14 patients of the treatment group and 13 patients of the control group.There was no difference between them(P>0.05).There was no hypo-congestion and reduction of PLT in the treatment group.13 patients presented with hypo-congestion,2 patients with reduction of PLT in the control group.Urine protein quantitation,albumin and cholesterol in the treatment group were as(5.3±3.2)g/24h,(13.3±4.1)g/L,and (9.9±2.8)g/L respectively before treatment.The former index changed as (2.3±1.5)g/24h,(25.3±6.3)g/L and(7.9±1.4)mmol/L respectively 4 weeks after treatment and as(0.9±0.7)g/24h,(32.6±3.5)g/L and (5.4±0.8)mmol/L respectively 8 weeks after treatment.There was statistical difference among them (P<0.05).Albumin recovered fast in the treatment group then in the control group,however,no difference was found (P> 0.05 ).Conclusion:Atomizaiton inhalation of low-molecular heparin (LMH) can improve HCS in CDNS,degrade urine protein and cholesterol and increase blood albumin.It can contribute to the early relief of CDNS.It has no hemorrhage complication and easy to perform and deserve to clinical application.更多还原