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目的 使用速避凝 (LMWH)治疗 36例难治性肾病 ,并与肝素 (SH)治疗 2 1例难治性肾病的疗效进行对比。方法 LMWH每次 0 0 10～ 0 0 12ml/kg ,1次 /d ,14d为一疗程 ;SH每次 1mg/kg ,1次 /d ,10～ 14d为一疗程。 结果 LMWH组尿蛋白转阴 2 1例 (5 8 3% ) ,尿蛋白减少 + +以下 11例 (30 6 % ) ,无效 4例 (11 1% ) ,总有效率 88 9% ;而SH组尿蛋白转阴 13例 (6 1 9% ) ,尿蛋白减少 + +以下 1例 (4 8% ) ,无效 7例 (33 3% ) ,总有效率 6 6 7% ;病理类型两组均以MCNS和MsPGN疗效最好 ,FSGS疗效较差。结论 LMWH和SH均有助于难治性肾病的缓解、降低高凝状态而无明显的副作用 ,但LMWH与SH相比 ,其生物利用度好 ,半衰期长 ,出血危险性小 ,且无血小板减少、肝功能损害、脱发、骨质疏松等副作用 ,是治疗儿童难治性肾病高凝状态的理想药物。
Objective To compare 36 cases of refractory nephropathy treated with rapid contraception (LMWH) and 21 cases of refractory nephropathy with heparin (SH). Methods LMWH was treated with 1 0 mg / kg, 1 time / day and 10 ~ 14 days as a course of treatment. Results In the LMWH group, urinary protein was negative in 21 (53.3%) cases and urinary protein in 11 (30.6%) cases less than + +, and 4 cases (11.1%) were ineffective with a total effective rate of 88.9% Urine protein was negative in 13 cases (61.9%), urinary protein decreased + + in 1 case (48%), invalid in 7 cases (33.3%), the total effective rate was 6 6 7% MCNS and MsPGN the best effect, FSGS less effective. Conclusion Both LMWH and SH are helpful to relieve the refractory nephropathy and reduce hypercoagulability without obvious side effects. However, compared with SH, LMWH has good bioavailability, long half-life, low bleeding risk, and no thrombocytopenia , Liver damage, hair loss, osteoporosis and other side effects, is an ideal drug for the treatment of refractory nephropathy in children with hypercoagulable state.