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肝素作为抗凝剂已经被广泛应用于肾病综合征合并血栓栓塞并发症的防治。由于许多不表现为肾病综合征的。肾小球肾炎患者虽然没有全身的血栓前状态,但肾小球局部有纤维蛋白相关抗原,尤其交联纤维蛋白、D-二聚体的沉积,提示肾小球局部存在高凝状态。肾炎患者肾小球内纤维蛋白相关抗原沉积与蛋白尿和肾功能减退显著相关;凝血酶和纤维蛋白均能通过多种机制导致肾小球系膜细胞和内皮细胞的损伤,因此,采用肝素防治肾炎合并肾小球内凝血酶活化、纤维蛋白相关抗原沉积和肾小球内凝血是合理的,而且事实上已经被不少临床和动物实验研究证实是有效的。另外,最近几年来人们对肝素的药理作用认识不断深入,发现肝素不仅可以抗凝、抗栓,而且具有抗炎、抗增殖等多种对于治疗肾小球疾病尤其增殖性肾炎有益的作用。
Heparin as an anticoagulant has been widely used in prevention and treatment of complications of nephrotic syndrome complicated by thromboembolism. Because many do not show nephrotic syndrome. Although there is no systemic glomerulonephritis in patients with glomerulonephritis, but glomerular local fibrin-related antigens, especially cross-linked fibrin, D-dimer deposition, suggesting hypercoagulable state of glomerular local presence. Nephritis glomerular fibrin-related antigen deposition and proteinuria and renal dysfunction were significantly related; thrombin and fibrin can cause a variety of mechanisms of mesangial cells and endothelial cell damage, therefore, the use of heparin Glomerular nephritis combined with thrombin activation, fibrin-related antigen deposition and glomerular coagulation is reasonable, and in fact has been confirmed by many clinical and animal experiments are valid. In addition, in recent years, people continue to deepen the understanding of the pharmacological effects of heparin and find that heparin can not only anticoagulant and antithrombotic effects, but also has a beneficial effect on the treatment of glomerular diseases, especially proliferative glomerulonephritis.