CAJ | 학술논문

目的：探讨低分子肝素钙（ LMWH）治疗原发性重症肾病综合征（ PSNS）的疗效。方法将40例临床诊断为PSNS的患者随机分成治疗组（21例）和对照组（19例），两组的基本治疗药物是强的松及非诺贝特。在基本治疗的基础上，治疗组应用低分子肝素钙5000 U · d-1皮下注射，对照组应用双嘧达莫50 mg囗服，3次/d，疗程均为4周。观察两组血纤维蛋白原（ FIB ）、24 h 尿蛋白、血清肌酐（ Scr ）、血清白蛋白（ALB）、血总胆固醇（TCHO）、甘油三酯（TG）、血小板（PLT ）、凝血酶原时间（ PT）、白陶土部分凝血酶时间（ APTT）的水平变化。结果与对照组相比，治疗组治疗后 FIB、TCHO、TG、24 h尿蛋白明显下降（ P＜0.05）， ALB明显上升（ P＜0.05）；Scr治疗后组间差异无统计学意义（ P＞0.05）。除治疗组有2例皮下出现瘀斑外，余未见其它副作用。结论在糖皮质激素的基础上加用LMWH治疗PSNS，可使患者的高凝状态明显缓解，防止血栓形成，并使TCHO、TG、尿蛋白明显下降，血清ALB上升，不仅使病情缓解，而且副作用较少。
목적：탐토저분자간소개（ LMWH）치료원발성중증신병종합정（ PSNS）적료효。방법장40례림상진단위PSNS적환자수궤분성치료조（21례）화대조조（19례），량조적기본치료약물시강적송급비낙패특。재기본치료적기출상，치료조응용저분자간소개5000 U · d-1피하주사，대조조응용쌍밀체막50 mg국복，3차/d，료정균위4주。관찰량조혈섬유단백원（ FIB ）、24 h 뇨단백、혈청기항（ Scr ）、혈청백단백（ALB）、혈총담고순（TCHO）、감유삼지（TG）、혈소판（PLT ）、응혈매원시간（ PT）、백도토부분응혈매시간（ APTT）적수평변화。결과여대조조상비，치료조치료후 FIB、TCHO、TG、24 h뇨단백명현하강（ P＜0.05）， ALB명현상승（ P＜0.05）；Scr치료후조간차이무통계학의의（ P＞0.05）。제치료조유2례피하출현어반외，여미견기타부작용。결론재당피질격소적기출상가용LMWH치료PSNS，가사환자적고응상태명현완해，방지혈전형성，병사TCHO、TG、뇨단백명현하강，혈청ALB상승，불부사병정완해，이차부작용교소。
Objetc ive To investigate the effects of low -molecular-weight heparin calcium ( LMWH) in pa-tients with primary severe nephritic syndrome ( PSNS) .Methods Forty patients with PSNS were divided randomly in-to treated groups(n=21) which was treated with LMWH of 5 000 U· d-1 injection under skin and control group (n=19) which was treated with Dipyridamole50 mg three times every day for 4 weeks.Two groups were treated with the same base of steroid and Fenofibrate .Plasma FIB, 24 h urinary protein, Scr, ALB, TCHO, TG, PLT, PT and APTT were observed.Results A significant decrease of plasma FIB , serum TCHO and TG was observed in the treated group compared with those in the control group after 4 weeks of treatment ( P<0.05 ) .A significant decrease of 24 h urinary protein and increase of serum ALB was observed in the treated group compared with those in the control group after 4 weeks of treatment ( P<0.05 ) .Only 2of the 21 patients in treated group complained of ecchymosis under skin.Conclusion The treatment with LMWH for PSNS can significantly decrease plasma FIB and protect against high thrombotic risk of PSNS, LMWH for PSNS can significantly decrease 24 h urinary protein, serum TCHO, TG and increase serum ALB , and it is helpful to relieve PSNS .