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目的观察低分子量肝素治疗糖尿病肾病的临床疗效和安全性。方法将 6 4例糖尿病肾病患者根据 2 4h尿白蛋白或蛋白定量分为早期糖尿病肾病 (30例 )和临床期糖尿病肾病 (34例 ) ,再随机分为治疗组和对照组。所有患者均给予降糖降压治疗 ;治疗组再予以低分子量肝素治疗 ,疗程 8周 ,观察血脂、血小板、纤维蛋白原、凝血酶原标准化比率、肝肾功能、内生肌酐清除率、2 4h尿白蛋白或蛋白定量变化及副作用。结果两期治疗组疗程后 ,血脂、胆固醇、纤维蛋白原、2 4h尿白蛋白或蛋白定量下降 ;临床糖尿病肾病治疗组血尿素氮、肌酐降低 ,内生肌酐清除率升高与治疗前及对照组治疗后比较均有显著性差异 (P <0 .0 1或 0 .0 5 )。结论低分子量肝素可安全有效的用于糖尿病肾病的临床治疗。
Objective To observe the clinical efficacy and safety of low molecular weight heparin in the treatment of diabetic nephropathy. Methods Sixty-four patients with diabetic nephropathy were divided into two groups according to 24 hours urinary albumin or protein: early diabetic nephropathy (30 cases) and clinical diabetic nephropathy (34 cases). The patients were randomly divided into treatment group and control group. All patients were given hypoglycemic and antihypertensive treatment. The treatment group was treated with low molecular weight heparin for 8 weeks. The levels of blood lipids, platelets, fibrinogen, prothrombin normalization rate, liver and kidney function, creatinine clearance rate, 24 h Urine albumin or protein quantitative changes and side effects. Results The blood lipid, cholesterol, fibrinogen and 24 h urinary albumin or protein were decreased in the two treatment groups after treatment. In the clinical diabetic nephropathy group, the blood urea nitrogen, creatinine and endogenous creatinine clearance were significantly higher than those before treatment and before treatment Group after treatment were significantly different (P <0. 01 or 0. 05). Conclusion Low molecular weight heparin is safe and effective for the clinical treatment of diabetic nephropathy.