目的 分析肾病综合征患儿行低分子肝素和泼尼松联合治疗的效果、相关临床指标及预后情况.方法 分析内蒙古医科大学附属医院2016年1月～2017年1月确诊的肾病综合征84例患儿资料,按照临床治疗方法选择不同分成两组,将单纯行低分子肝素治疗42例患儿设为对照组,将低分子肝素和泼尼松联合治疗42例患儿设为观察组,治疗1个月后,比较两组凝血指标、血总胆固醇、血浆白蛋白和24h尿蛋白水平等相关临床指标及预后肾功能、生活质量.结果 两组活化部分凝血活酶、凝血酶原所需时间和不良反应发生率比较,差异无统计学意义(P＞0.05).观察组治疗后血总胆固醇、24 h尿蛋白水平均比对照组低,血浆白蛋白比对照组高,差异有高度统计学意义(P＜0.01).观察组治疗后肌酐清除率和生活质量各项评分均比对照组高,且尿素氮、血肌酐水平均比对照组低,差异有高度统计学意义(P＜ 0.01).结论 肾病综合征患儿行低分子肝素和泼尼松联合治疗,不仅能够优化相关临床指标、提高疗效、减少不良反应,还能促进预后改善,具有一定临床应用与研究价值.%Objective To analyze the clinical effects,relevant indicators and prognosis of Low Molecular Heparin Combined with Prednisone in the treatment of children with nephrotic syndrome.Methods Clinical data of 84 children confirmed to be with nephrotic syndrome in Affiliated Hospital of Inner Mongolia Medical University were analyzed from January 2016 to January 2017,and they were divided into two groups according to different treatment methods applied:42 cases were given only Low Molecular Heparin for treatment as control group,while the other 42 children were treated with Low Molecular Heparin combined with Prednisone as observation group.The clinical indicators including coagulation indicators,total cholesterol,plasma albumin and 24-h proteinuria,renal function after prognosis,and life quality were compared between two groups for one month after treatment.Results The time for activation of partial thromboplastin and prothrombin,incidence rate of adverse reactions between two groups were compared,with no statistical differences (P ＞ 0.05).After treatment,serum total cholesterol and 24-h proteinuria levels of observation group were both lower than those of control group,and plasma albumin of observation group was higher than that of control group,the differences were statistically significant (P ＜ 0.01).After treatment,the creatinine clearance rate and quality of life scores in observation group were higher than those in control group,urea nitrogen,serum creatinine in observation group were lower than those in control group,the differences were statistically significant (P ＜ 0.01).Conclusion Children with nephrotic syndrome are treated with Low Molecular Heparin combined with Prednisone,these treatment will improve the curative effect,and reduce adverse reaction,but also promote the prognosis effect.Therefore,this therapy is significant value to be popularized in clinical application and for research.
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