【摘要】 目的：研究不同临床类型原发性肾小球疾病凝血系统对大剂量肝素的耐受性。方法：２７例原发性肾小球肾炎病人分成I型肾病综合征组（Ⅰａ组）６例，Ⅱ型肾病综合征组（Ⅰb组）７例，慢性肾炎普通型组（Ⅱ组）７例，肾病综合征缓解组（Ⅲ组）７例。给予肝素 １２５０0 ＩＵ加于 １０％葡萄糖注射液 ５００ ｍＬ中iＶ，ｇｔｔ。观察初次使用肝素前后全血凝血时间的变化，同时测定尿蛋白、血清清蛋白及血清总蛋白。结果：（１）使用肝素后，在Ⅰａ组和Ⅰb组ＰＣＴ显著延长，但其延长的程度[（ ＰCT-ＢＣＴ）÷ ＴＣＴ × １００％，ΔＣＴ]显著低于 Ⅱ组和 Ⅲ组，ΔＣＴ在 Ⅰａ组和 Ⅰb组之间、Ⅱ组和Ⅲ组之间无显著差异；（２）ΔＣＴ与尿蛋白量有显著负相关，与清蛋白及总蛋白有显著正相关。结论：Ⅰ型和Ⅱ型肾病综合征，血液凝血机能对肝素的耐受性比慢性肾炎普通型及缓解期肾病综合征病人强；有效治疗后，随着尿蛋白量的下降，血液凝血机能对肝素的耐受性也下降。更多还原

【Abstract】 AIM: To study the heparin tolerance of coagulative system in glomerulonephritic patients. METHODS: Twenty-seven primary glo- merulonephritis patients were divided into the following 4 groups: type I nephrotic sysdrome(group Ia) of 6 patients, type Ⅱ nephrotic syndrom(group Ⅰb) of 7 patients, chronic glomerulonephritis ordinary type (group Ⅱ) of 7 patient and nephrotic syndrome in complete remission stage (group Ⅲ) of 7 patients. The main investigating parameters were the whole blood coagulating time (CT) (in tubule method) performed before (BCT) and after (PCT) the first administration of heparin (12500 U in 10% glucose injection 500 mL iv gtt), the urine protein excretion rate and the serum proteins. RESULTS: (1)When the heparin was given, the PCTs of group Ⅰa and group Ⅰb were prolonged significantly, and the ΔCTs = ([PCT- BCT] ÷ BCT)× 100%, ΔCTs of above two groups were significantly less than that of the group Ⅱ and group Ⅲ, but there was no significant difference between group Ⅰa and group Ⅰb. So was that of group Ⅱ and group Ⅲ. (2) There were a negative correlationship between ΔCT and urine protein excretion rate and positive correlationships between ΔCT and serum albumin(Alb), and between ΔCT and serum total protein(TPro). CONCLUSION: The heparin tolerance of the coagulative system in both type Ⅰ and type Ⅱ nephrotic syndrome patients is better than that of chronic glomerulonephritis ordinary type patients and the completely relieved nephrotic patients. When nephrotic syndrome is ameliorated the heparin tolerance reduceds accordingly.更多还原