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目的:观测并评价低分子肝素治疗伴高凝状态的肾小球疾病的疗效和副作用。方法:按配伍组设计,在常规治疗基础上,15例应用低分子肝素(达肝素钠Fragmin)治疗,剂量为50～60IU/kg·d,于治疗前、治疗1周及治疗2周分别检测凝血酶原时间比值(PTR)及纤维蛋白原含量(FIB),另设15例患儿应用普通肝素作为对照。结果:低分子肝素组治疗前PTR及FIB值分别为(0.727±0.103)及(4.930±0.369)g/L治疗1周后RTR及FIB值分别为(0.776±0.995)及(4.558±0.305)g/L,与治疗前相比无显著差异P>0.05)。治疗2周后PTR及PIB值分别为(0.891±0.672)及(3.884±0.157)g/L,与治疗前相比有显著差异P<0.01)。而且治疗2周后PTR及FIB值与治疗1周相比有差异P<0.05)低分子肝素组治疗1周及2周后PTR及FIB值与用普通肝素组治疗相比均无显著性差异P>0.05)结论低分子肝素疗效肯定,无副作用,半衰期长,无需检测,无大出血危险,临床应用前景广阔。
Objective: To observe and evaluate the efficacy and side effects of low molecular weight heparin in the treatment of glomerular diseases with hypercoagulable state. Methods: According to the design of compatibility group, 15 cases were treated with low molecular weight heparin (Fragmin) at the dose of 50 ~ 60 IU / kg · d on the basis of conventional treatment, and were detected before treatment, after treatment for 1 week and after 2 weeks Prothrombin time ratio (PTR) and fibrinogen content (FIB), and the other 15 cases of children with unfractionated heparin as a control. Results: The values of PTR and FIB in low molecular weight heparin group before treatment were (0.727 ± 0.103) and (4.930 ± 0.369) g / L, respectively, and the values of RTR and FIB were (0.776 ± 0.995) and (4.558 ± 0.305) g / L, no significant difference compared with before treatment P> 0.05). After 2 weeks of treatment, PTR and PIB values were (0.891 ± 0.672) and (3.884 ± 0.157) g / L, respectively, which were significantly different from those before treatment (P <0.01). And PTR and FIB values after 2 weeks of treatment were significantly different from those of 1 week of treatment (P <0.05). PTR and FIB values in low molecular weight heparin group after 1 week and 2 weeks were not significantly different from those in unfractionated heparin group P > 0.05) Conclusions The low molecular weight heparin has definite curative effect, no side effect, long half-life, no need of testing and no risk of major bleeding, and has broad clinical application prospect.