中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2009年
3期
237-239
,共3页
低分子肝素钙%过敏性紫癜%肾损害%儿童
低分子肝素鈣%過敏性紫癜%腎損害%兒童
저분자간소개%과민성자전%신손해%인동
Low molecular heparin calcium%Henoch-Schoenlein Purpura%Henoeh-Schonlein purpura nephritis%Children
目的 观察低分子肝素钙治疗过敏性紫癜(HSP)及预防过敏性紫癜肾损害的临床疗效.方法 采用前瞻性随机对照法,将103例HSP患儿分为肝素组(57例)和对照组(46例),肝素组在一般综合治疗基础上加用低分子肝素钙100～125 U/(kg·次)静脉滴注,1次/d,连用10～14 d.观察两组患儿症状、体征消失时间,皮疹反复发生率,治疗前、后D-二聚体及早期肾损害指标的变化.结果 肝素组皮肤紫癜、关节肿痛、腹痛的消退时间分别为(15.23±3.14)d、(6.80±1.96)d、(6.68±3.42)d,较对照组[(17.11±4.79)d、(8.30±2.67)d、(8.59±4.09)d]明显缩短,差异有显著性(P＜0.05);皮疹反复发生率为14.6%,较对照组(39.1%)低,差异有非常显著性(P＜0.01);随访3个月时D-二聚体阳性率为15.8%,较对照组(37.0%)降低,差异有显著性(P＜0.05);早期肾损害指标尿中微量蛋白、β2微球蛋白、N-乙酰-β-D-氨基葡萄糖苷酶水平分别为(12.22±3.92)mg/L、(5.35±0.51)mg/L、(8.12±1.65)U/L,较对照组[(14.15±5.17)mg/L、(6.54±2.67)mg/L、(10.04±2.60)U/L]明显降低,差异有显著性(P＜0.01,P＜0.05).结论 低分子肝素缩短HSP病程,并可有效预防过敏性紫癜肾损害的发生.
目的 觀察低分子肝素鈣治療過敏性紫癜(HSP)及預防過敏性紫癜腎損害的臨床療效.方法 採用前瞻性隨機對照法,將103例HSP患兒分為肝素組(57例)和對照組(46例),肝素組在一般綜閤治療基礎上加用低分子肝素鈣100～125 U/(kg·次)靜脈滴註,1次/d,連用10～14 d.觀察兩組患兒癥狀、體徵消失時間,皮疹反複髮生率,治療前、後D-二聚體及早期腎損害指標的變化.結果 肝素組皮膚紫癜、關節腫痛、腹痛的消退時間分彆為(15.23±3.14)d、(6.80±1.96)d、(6.68±3.42)d,較對照組[(17.11±4.79)d、(8.30±2.67)d、(8.59±4.09)d]明顯縮短,差異有顯著性(P＜0.05);皮疹反複髮生率為14.6%,較對照組(39.1%)低,差異有非常顯著性(P＜0.01);隨訪3箇月時D-二聚體暘性率為15.8%,較對照組(37.0%)降低,差異有顯著性(P＜0.05);早期腎損害指標尿中微量蛋白、β2微毬蛋白、N-乙酰-β-D-氨基葡萄糖苷酶水平分彆為(12.22±3.92)mg/L、(5.35±0.51)mg/L、(8.12±1.65)U/L,較對照組[(14.15±5.17)mg/L、(6.54±2.67)mg/L、(10.04±2.60)U/L]明顯降低,差異有顯著性(P＜0.01,P＜0.05).結論 低分子肝素縮短HSP病程,併可有效預防過敏性紫癜腎損害的髮生.
목적 관찰저분자간소개치료과민성자전(HSP)급예방과민성자전신손해적림상료효.방법 채용전첨성수궤대조법,장103례HSP환인분위간소조(57례)화대조조(46례),간소조재일반종합치료기출상가용저분자간소개100～125 U/(kg·차)정맥적주,1차/d,련용10～14 d.관찰량조환인증상、체정소실시간,피진반복발생솔,치료전、후D-이취체급조기신손해지표적변화.결과 간소조피부자전、관절종통、복통적소퇴시간분별위(15.23±3.14)d、(6.80±1.96)d、(6.68±3.42)d,교대조조[(17.11±4.79)d、(8.30±2.67)d、(8.59±4.09)d]명현축단,차이유현저성(P＜0.05);피진반복발생솔위14.6%,교대조조(39.1%)저,차이유비상현저성(P＜0.01);수방3개월시D-이취체양성솔위15.8%,교대조조(37.0%)강저,차이유현저성(P＜0.05);조기신손해지표뇨중미량단백、β2미구단백、N-을선-β-D-안기포도당감매수평분별위(12.22±3.92)mg/L、(5.35±0.51)mg/L、(8.12±1.65)U/L,교대조조[(14.15±5.17)mg/L、(6.54±2.67)mg/L、(10.04±2.60)U/L]명현강저,차이유현저성(P＜0.01,P＜0.05).결론 저분자간소축단HSP병정,병가유효예방과민성자전신손해적발생.
Objective To investigate the curative effect of low molecular heparin calcium on Henoch-Schoenlein purpura(HSP) and the preventive effect on Henoch-schonlein purpura nephritis.Methods One hundred and three patients with HSP were enrolled in the study and divided randomly into two groups,heparin group(57 cases) and control group(46 cases).Heparin group received low molecular heparin calcisymptom remission time,the incidence of recurrent skin rash were recorded.The contents of D-dipolymer and the three indicators of early renal damage were detected before and after the treatment.Results The remission times of purpura,joint pain and abdominal pain in heparin group[(15.23±3.14) d,(6.80±1.96) d and(6.68±3.42) d]were significantly shorter than those of control group[(17.11±4.79) d,(8.30±2.67)d,(8.59±4.09) d](P ＜0.05).The incidence of recurrent skin rash in heparin group(14.6%) was significantly lower than that of control group(39.1%)(P＜0.01).Compared to control group,the positive rate of D-dipolymer in heparin group was higher(15.8% vs 37.0%),and the urine levels of mALB,β2-MG and NAG were significantly decreased[(12.22±3.92) mg/L,(5.35±0.51) mg/L,(8.12±.65) U/L vs (14.15±5.17) mg/L,(6.54±2.67) mg/L,(10.04±2.60) U/L]during 3 months after treatment(P＜0.01,P ＜0.05).Conclusion Low molecular heparin can shorten the course of HSP and prevent the development of Henoch-Schonlein purpura nephritis.
