Preventive And Therapeutic Effect Of Lower Molecular Weigh Heparin Sodium On The Development Of Nephropathy In Henoch-Schoenlein Purpura

Henoch-Schoenlein Purpura (HSP) is one kind of common diffuse angiopathy in the Pediatrics Department, and shows the increasing tendency year by year. Purpura Nephritis (HSPN)is the common complication of the HSP, and it affects a lot on the prognosis of the disease. So far, there is still no specific medicine. As the anticoagulant medicine, heparin has been serving the clinic for 60 years, whereas as one kind of powerful anticoagulant medicine, Lower Molecular Weigh Heparin Sodium (LMWH Sodium) has been more and more applied to clinical treatment. In recent years, many studies proved that, the heparin may inhibit the proliferation of the glomerular mesangial cells and the endothelial cells, may take the anti-inflammation activity by inhibiting the endothelial cell, the blood platelet, the white blood cell and the proteinase, and may inhibit the producing of fibronectin and the collagen, thereby it can prevent the cirrhosis of glomerulus. Moreover, Lower Molecular Weigh Heparin Sodium takes on many negative charges, which is advantageous to protect the negative charge barrier of the glomerular basement membrane (GBM), and prevent the leakage of albumin.The LMWH Sodium can directly affect the occurrence mechanism of the immune complex nephritis, and prevents the immune complex depositing at GBM. Therefore, theoretically speaking, the heparin may block many links which HSPN arises, and is the extremely significant medicine in the aspect of preventing and controlling the HSPN with renal involvement. This study is to observe the clinical validity of the LMWH Sodium preventing and controlling the Henoch-Schoenlein Purpura Nephritis .Methods: One hundred and seventy patients with HSP were enrolled in the study and divided randomly into two groups: LMWH sodium group (H) and control group (C). In H group, eighty-six patients were administrated with sodium LMWH sodium subcutaneously (100iu/kg.day) for seven days at the onset of HSP; whereas eighty-four patients as C group only received vehicles. All patients were also medicated with other commonly used drugs, such as Vitamin C and Vitamin P, and followed up for more than six months.Results: The patient numbers of developing nephritis were four (4.65%) in H group and twenty-eight (33.3%) in C group respectively. The incidence of nephritis in H group was obviously lower than that in C group (P<0.05). The occurrence of nephritis in H group was significantly delayed than that in C group[(82±64)days VS(34±32)days, P<0.01]. In H group, the urine protein excretion was (50.75±32.9)mg, and the urine counting of red cells was (0.6048±1.8224)104 /h before the therapy of the LMWH Sodium; whereas, after the therapy, they were (28.1±13.32)mg and (0.6048±1.8224)10~4/h respectively(P<0.05). The clinical characteristics of renal involvement in H and C groups consisted of 2 cases (50%) and 12 cases (43%)of simple hematuria, 1 case (25%) and 14 cases (50%) of hematuria plus proteinuria, 2 cases (7.27%) of hematuria plus nephrosis, respectively. No severe side effects, such as hleeding, were observed during the process of LMWH Sodium treatment.Conclusion: LMWH Sodium, could significantly reduce the incidence of HSP nephritis (HSPN) and improve the prognosis of HSP.