【摘要】：目的:探討雷公藤多苷聯(lián)合丹參注射液治療過(guò)敏性紫癜性腎炎患兒對(duì)凝血機(jī)制的影響,并進(jìn)行療效評(píng)價(jià)。方法:過(guò)敏性紫癜性腎炎患兒103例根據(jù)隨機(jī)數(shù)字表分為常規(guī)治療組51例和聯(lián)合治療組52例。常規(guī)治療組采用飲食控制、激素、抗凝和雷公藤多苷片治療,聯(lián)合治療組在常規(guī)治療組基礎(chǔ)上加用丹參注射液靜脈滴注。觀察兩組治療前后凝血指標(biāo)(D-二聚體、抗凝血酶Ⅲ、凝血酶時(shí)間、凝血酶原時(shí)間、活化部分凝血時(shí)間、纖維蛋白原、血小板)和血栓彈力圖[凝血反應(yīng)時(shí)間(R)、凝血形成時(shí)間(K)、α角、最大振幅(MA)、血凝塊溶解百分比(EPL)、凝血指數(shù)(CI)、30 min血凝塊幅度減少速率(Ly30)]變化,觀察皮膚紫癜、關(guān)節(jié)痛、腹痛、黑變和(或)便血消失時(shí)間及不良反應(yīng)發(fā)生情況,隨訪6個(gè)月觀察患兒過(guò)敏性紫癜、過(guò)敏性紫癜性腎炎復(fù)發(fā)情況,并對(duì)兩組治療效果進(jìn)行評(píng)價(jià)。結(jié)果:兩組治療后D-二聚體、抗凝血酶Ⅲ、凝血酶時(shí)間、凝血酶原時(shí)間、活化部分凝血時(shí)間、纖維蛋白原、血小板、R、K、MA、EPL、Ly30水平與治療前比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),但常規(guī)治療組凝血酶時(shí)間、凝血酶原時(shí)間與治療前比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。聯(lián)合治療組治療后D-二聚體、纖維蛋白原、血小板、MA、EPL水平低于常規(guī)治療組,而抗凝血酶Ⅲ、凝血酶時(shí)間、凝血酶原時(shí)間、K水平高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。聯(lián)合治療組皮膚紫癜、關(guān)節(jié)痛、腹痛、黑變和(或)便血消失時(shí)間均少于常規(guī)治療組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。常規(guī)治療組不良反應(yīng)發(fā)生率為7.8%,聯(lián)合治療組為5.8%,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患兒隨訪6個(gè)月,過(guò)敏性紫癜、過(guò)敏性紫癜性腎炎復(fù)發(fā)率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。兩組療效比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:雷公藤多苷聯(lián)合丹參注射液治療過(guò)敏性紫癜性腎炎患兒能夠顯著改善患兒凝血情況和臨床癥狀,無(wú)明顯不良反應(yīng)情況發(fā)生,療效確切,有可能降低復(fù)發(fā)率。
[Abstract]:Objective: to investigate the effect of tripterygium wilfordii polyglycoside and salvia miltiorrhiza injection on coagulation mechanism in children with Henoch-Schonlein purpura nephritis. Methods: 103 children with Henoch-Schonlein purpura nephritis were randomly divided into routine treatment group (n = 51) and combined treatment group (n = 52). Diet control, hormone, anticoagulant and tripterygium wilfordii polyglycosides were used in routine treatment group, and salvia miltiorrhiza injection was added in combined treatment group. The parameters of coagulation (D-dimer, antithrombin 鈪，

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