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目的观察低分子肝素联合灯盏细辛治疗原发性肾病综合症的临床疗效。方法以58例确诊为原发性肾病综合症患者为研究对象,随机分为对照组与治疗组各29例。对照组常规给予激素和(或)免疫抑制剂、利尿以及潘生丁抗血小板等治疗,治疗组在常规治疗基础上加用灯盏细辛联合低分子肝素治疗,连用2周。观察治疗前后患者尿量、体重和24h尿蛋白、血清白蛋白(ALB)、血清甘油三酯(TG)、总胆固醇(Chol)以及凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)等变化。结果与对照组相比,治疗组2周后尿量明显增加、体重明显下降(p<0.05),24h尿蛋白明显减少,ALB增加,TG和Chol明显下降(p<0.05)。主要凝血指标除PT无明显变化外,APTT明显延长、FIB和D-D明显下降(p<0.05)。结论低分子肝素联合灯盏细辛可明显增加原发性肾病综合症患者尿量,降低体重和尿蛋白、提高血清白蛋白,降低血脂,改善患者的高凝状态,对原发性肾病综合症具有良好的治疗作用。
Objective To observe the clinical efficacy of low molecular weight heparin combined with Erigeron Breviscapus in the treatment of primary nephrotic syndrome. Methods Fifty-eight patients with primary nephrotic syndrome were selected as study subjects and randomly divided into control group and treatment group with 29 cases each. The control group was given hormones and / or immunosuppressive agents, diuretic and anti-platelet therapy such as dipyridamole. The treatment group was treated with Erigeron Breviscapus combined with low molecular weight heparin on the basis of routine treatment for 2 weeks. Before and after treatment, the urine volume, body weight and 24h urine protein, serum albumin (ALB), serum triglyceride (TG), total cholesterol (Chol), prothrombin time (PT), activated partial thromboplastin time (APTT ), Fibrinogen (FIB), D-dimer (DD) and other changes. Results Compared with the control group, the urine volume of the treatment group increased significantly after 2 weeks, the body weight decreased significantly (p <0.05), the proteinuria of 24 h decreased significantly, ALB increased, TG and Chol decreased significantly (p <0.05). In addition to the main coagulation index PT no significant change, APTT was significantly prolonged, FIB and D-D decreased significantly (p <0.05). Conclusion Low molecular weight heparin combined with erigeron can significantly increase the urine volume of patients with primary nephrotic syndrome, reduce body weight and urine protein, increase serum albumin, lower blood lipids and improve hypercoagulability in patients with primary nephrotic syndrome has Good therapeutic effect.