【摘要】 目的探讨大剂量低分子肝素钙治疗过敏性紫癜性肾炎的疗效,并与常规治疗组比较。方法按入院先后顺序将49例(包括8例成人)过敏性紫癜性肾炎分为对照组(24例)和治疗组(25例)。对照组给予常规治疗:每天口服泼尼松1 mg·kg-1·d-1,氯苯拉敏(8 mg,每日三次),环磷酰胺(2 mg·kg-1·d-1);每日静脉注射维生素C 4～6 g及10%葡萄糖酸钙10 ml。治疗组除常规治疗外,静脉注射低分子肝素钙150 U·kg-1·d-14周,其后皮下注射50 U·kg-1·d-1,时间4周。观察皮肤紫癜复发次数、尿常规、24 h尿蛋白定量、肝功能、血常规、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)。观察时间为2月。结果治疗组2、4、6周时尿红细胞及尿蛋白明显少于对照组(P<0.05或P<0.01),治疗组皮肤紫癜及血尿蛋白尿复发率明显低于对照组(P<0.05或P<0.01)。结论低分子肝素钙治疗过敏性紫癜性肾炎,可以明显减少其复发,并明显减少血尿和蛋白尿,而且安全可靠。更多还原

【Abstract】 Objective To evaluate the effectivity of large dose low molecular heparin calcium in the treatment of Schonlein-Henoch purpura nephritis.Methods Forty-nine cases(8 adult and 41 children) of Schonlein-Henoch purpura nephritis were divided into 2 groups according to the time of admission.Control group(24 cases) received routine treatment:oral prednisone(1 mg·kg-1·d-1),chlorphenamine(8 mg ·d-1),cyclophosphamide(2 mg·kg-1·d-1) and intravenous injection of vitamin C(3～6 g,one time each day) and 10% calcium gluconate(10 ml,one time each day).In addition to the routine treatment,treatment group(25 cases) received low molecular heparin calcium first in the dose of 150 U·kg-1·d-1 for 4 weeks via intravenous injection,then in the dose of 50 U·kg-1·d-1 for another 4 weeks via subcutaneous injections.The relapse rate of Schonlein-Henoch purpura and the following parameters including urine red blood cell,24 hr’s urine protein,liver function,platelets,prothrombin time and activated partial thromboplastin time were followed-up for 2 months.Results Significant decreases of urine red blood cell,24 hr’s urine protein,and significant decreased relapse rates of skin purpura,hematuria and proteinuria in low molecular heparin calcium treated group were observed when compared with those in control group.Conclusion Low molecular heparin calcium is safe and has better effect on reducing the relapse rate of Schonlein-Henoch purpura nephritis and on decreasing hematuria and proteinuria.更多还原