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Clinical study on different dosages of low molecular heparin combined with prednisone in treatment of refractory nephrotic syndrome
Author(s): 
Pages: 171-175
Year: Issue:  2
Journal: World Phytomedicines

Keyword:  Low Molecular Heparin Calcium InjectionPrednisone Acetate Tabletsrefractory nephrotic syndromehypercoagulabale state;
Abstract: Objective To explore the effect of different dosages of low molecular heparin combined with prednisone in treatment of refractory nephrotic syndrome. Methods The patients with refractory nephrotic syndrome(128 cases) of the First People’s Hospital of Yueyang from September 2012 to April 2014 were randomly divided into control, large, medium and small dosage groups, and each group had 32 cases. The patients in the control group were po administered with Prednisone Acetate Tablets 1 mg/(kg·d). The dosage gradually fell to maintain level 5 — 10 mg/d after 8 weeks. The patients in low molecular heparin large, medium and small dosages groups were sc administered with Low Molecular Heparin Calcium Injection 3075 U/time on the basis of the control group, large dosage group twice daily; medium dosage group once daily; small dosage group once two days. Four groups were continuously treated for 6 months. After treatment, the clinical efficacy in four groups were evaluated, while the changes of 24 h urine protein quantity, ALB, CREA, PT, APTT, FIB, TG, LDL, HDL, and TC were compared. Results After treatment, remission rate in the control group, large, medium and small dosage groups were 65.0%, 95.0%, 85.0%, and 70.0%. The remission rate in large, medium dosage groups were obviously higher than that in control group, while remission rate in large dosage group was obviously higher than that in medium and small dosage groups, and the difference was statistically significant(P < 0.05). Urine protein quantity of 24 h in four groups significantly reduced, and ALB significantly elevated, and the differences were statistically significant before and after treatment in the same group(P < 0.05). CREA in large, medium and small dosage groups significantly reduced with the significant difference(P < 0.05). The improvement degrees of 24 h urine protein quantity, ALB, and CREA in large dosage group were better than the other three groups with the significant difference(P < 0.05). TG, TC, and LDL in large, medium and small dosage groups significantly reduced, and the differences were statistically significant before and after treatment in the same group(P < 0.05). The improvement degrees in large, medium and small dosage groups were better than control group with the significant difference(P < 0.05). PT and APTT in large, medium and small dosage groups were significantly longer, and those in large dosage group were longer than medium and small dosage groups(P < 0.05). FIB in three dosage groups were significantly reduced, and large dosage group was lower than the low dosage group(P < 0.05). Conclusion Low molecular heparin combined with prednisone has a good clinical efficacy in treatment of refractory nephrotic syndrome, and can improve the hypercoagulabale state, especially the curative effect of large dosage group is better.
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