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双嘧达莫与低分子肝素对肾病综合征患儿凝血功能、肾功能、内皮功能及β2糖蛋白I/氧化低密度脂蛋白复合物的影响
Effects of Dipyridamole and low molecular weight heparin on coagulation function, renal function, endothelial function, and β2-glycoproteinⅠ/oxidized low-density lipoprotein complex in children with nephrotic syndrome
收稿日期:2023-06-28  
DOI:10.20047/j.issn1673-7210.2024.03.22
关键词:  双嘧达莫  低分子肝素  肾病综合征  β2糖蛋白Ⅰ/氧化低密度脂蛋白复合物
Key Words:
基金项目:广西高校中青年教师科研基础能力提升项目(2021KY0313)
作者单位
林勇 广西中医药大学第一附属医院教学部广西南宁 530023 
孟立锋 广西中医药大学第一附属医院肾病科 广西南宁 530023 
覃柳菊 广西中医药大学第一附属医院儿科广西南宁 530023 
李鹏 广西中医药大学第一附属医院儿科广西南宁 530023 
许欣 广西中医药大学第一附属医院医院办公室广西南宁 530023 
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摘要:目的 研究双嘧达莫与低分子肝素对肾病综合征患儿凝血功能、肾功能、内皮功能及β2糖蛋白Ⅰ(β2-GPⅠ)/氧化低密度脂蛋白(ox-LDL)复合物的影响。 方法 选取广西中医药大学第一附属医院2021年4月至2022年6月收治的90例肾病综合征患儿,按照随机数字表法将其分为对照A组(30例)、对照B组(30例)和观察组(30例)。对照A组给予甲泼尼龙+低分子肝素治疗,对照B组给予甲泼尼龙+双嘧达莫治疗,观察组行甲泼尼龙+低分子肝素+双嘧达莫治疗,三组均连续治疗30 d。比较三组治疗效果;比较三组治疗前后凝血功能指标[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)],肾功能指标[尿素氮(BUN)、胱抑素C(CysC)、血肌酐(Scr)、24 h尿蛋白定量],内皮功能指标[内皮素1(ET-1)、血管性血友病因子(vWF)]及β2-GPⅠ/ ox-LDL复合物;观察组三组不良反应发生情况。 结果 观察组与对照A组疗效比较,差异无统计学意义(P>0.05);观察组疗效优于对照B组(P<0.05)。治疗后,观察组APTT、PT水平长于对照A组和对照B组(P<0.05)。治疗后,观察组D-D、FIB、BUN、CysC、Scr、24 h尿蛋白定量、ET-1、vWF、β2-GPⅠ/ox-LDL复合物水平低于对照A组和对照B组(P<0.05)。观察组与对照A组不良反应总发生率比较,差异无统计学意义(P>0.05);观察组与对照B组不良反应总发生率比较,差异无统计学意义(P>0.05)。 结论 双嘧达莫联合低分子肝素可提高肾病综合征患儿临床疗效,改善凝血功能及肾功能,且用药安全性高。
Abstract:Objective To investigate the effects of Dipyridamole and low molecular weight heparin on coagulation function, renal function, endothelial function, and β2-glycoproteinⅠ (β2-GPⅠ)/oxidized low-density lipoprotein(ox-LDL) complex in children with nephrotic syndrome. Methods Ninety children patients with nephrotic syndrome admitted to the First Affiliated Hospital of Guangxi University of Chinese Medicine from April 2021 to June 2022 were selected and they were divided into control group A (30 cases), control group B (30 cases), and observation group (30 cases) by random number table method. Control group A was given Methylprednisolone+low molecular weight heparin treatment, control group B was given Methylprednisolone+Dipyridamole treatment, observation group was given Methylprednisolone+low molecular weight heparin+Dipyridamole treatment, all three groups were treated continuously for 30 days. The treatment effects of three groups were compared; the coagulation function indexes(prothrombin time [PT], activated partial thromboplastin time [APTT], fibrinogen [FIB], and D-dimer [DD]), kidney function indexes (urea nitrogen [BUN], cystatin C [CysC], serum creatinine [Scr], and 24-hour urine protein quantification), and endothelial function indexes (endothelin-1 [ET-1], von Willebrand factor [vWF]), and β2-GPⅠ/ox-LDL complex were compared; the occurrence of adverse reactions in three groups was observed. Results There was no significant difference between observation group and control group A (P>0.05); the curative effect of observation group was better than that of control group B (P<0.05). After treatment, APTT and PT in observation group were longer than those in control group A and control group B (P<0.05), while the levels of D-D, FIB, BUN, CysC, Scr, 24-hour urine protein quantification, ET-1, vWF, β2-GPⅠ/ox-LDL complex were lower than those of control group A and control group B (P<0.05). There was no significant difference in the total incidence of adverse reactions between observation group and control group A (P>0.05); there was no significant difference in the total incidence of adverse reactions between observation group and control group B (P>0.05). Conclusion Dipyridamole combined with low molecular weight heparin can improve the clinical efficacy, coagulation function, and renal function in children with nephrotic syndrome, and has high safety.
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