| Objective This research is in an attempt to study correlations between blood coagulation and fibrinolytic system disorders and the development of HSP and HSPN and then provide further evidence for the study of pathogenesis of HSP as well as their clinical treatment through detecting PT,APTT,TT,FIB,FDP,D-Dimer and activity of AT-?in plasma respectively as well as PAI-1 levels in plasma and urine of both Chinese herbs group and Chinese herbs combined with heparin group with Henoch-Sch(?)nlein purpura,and Chinese herbs combined with heparin group with Henoch-Sch(?)nlein purpura nephritis before and after treatment respectively.Methods One hundred and ten children cases with HSP and HSPN admitted to the ward 1 of pediatrics in the First Affiliated Hospital of Henan University of Chinese Medicine from October,2015 to February,2016 were observed in this study of which 65 cases with HSP and 45 with HSPN.The plasma and urine were collected before treatment,1 week and 1 month after the treatment respectively.And 20 cases with HSP were treated with Chinese herbs besides conventional treatment.45 cases with HSP and 45 cases with HSPN were treated with Liangxue Jiedu Huoxue Formula combined with low molecular weight heparin besides conventional treatment.In the meanwhile,urines of 30 healthy children cases were collected as control.PT,APTT,TT,FIB,FDP,D-Dimer and AT-? in the plasma and PAI-1 in both plasma and urine were detected as well.Observe changes of the indexes in plasma before and after 1 week treatment,and observe the changes of urine PAI-1 before treatment and 4 weeks after treatment.Results1.The level of Plasma AT-?activity was higher in children with HSPN than that with HSP.The difference of PT,APTT,TT,FIB,FDP,D-Dimer and PAI-1 levels in plasma between HSP and HSPN in children was not statistically significant(P>0.05).The AT-III level in plasma of children with HSPN in early onset increased higher when compared to that of children with HSP,which indicated that there was statistical significance between them(P<0.05).2.The level of plasma FIB,D-Dimer,FDP was decreased in children with HSP after 1 week treatment,while children with HSPN had D-Dimer and FDP decreased.The difference between pre-treatment and post-treatment FIB,D-Dimer and FDP in plasma of Chinese herbs group with HSP was statistically significant(P<0.05),while there was no statistical significance(P>0.05)in terms of other indexes.The difference between pre-treatment and post-treatment FIB,D-Dimer and FDP in plasma of Chinese herbs combined with low molecular weight heparin treatment group with HSP is statistically significant(P<0.05),while there was no statistical significance(P>0.05)in terms of other indexes.The difference between pre-treatment and post-treatment D-Dimer and FDP in plasma of Chinese herbs combined with low molecular weight heparin treatment group with HSPN is statistically significant(P<0.05),while there was no statistical significance(P>0.05)in terms of other indexes.3.Children with HSP using the treatment of pure Chinese herbs and Chinese herbs combined with low molecular weight heparin both could improve blood coagulation state.The differences of coagulation indexes in plasma after 1 week treatment between the treatment of pure Chinese herbs and Chinese herbs combined with low molecular weight heparin had no statistical significance(P>0.05).4.Before treatment,the mean value of urine PAI-1 / Cr in children with HSP was higher than that of the control group,while that of urine PAI-1 / Cr in HSPN group was highest.The mean value of urine PAI-1 / Cr was decreased in children both with HSP and HSPN 4 weeks after treatment.The mean value of urine PAI-1/Cr in children with HSPN?HSP was higher than that of healthy children,and difference between the two groups was statistically significant(P<0.05).The mean value of urine PAI-1/Cr in HSPN children was higher than that of HSP children,and difference between the two groups was statistically significant(P<0.05).The mean value of urine PAI-1/Cr 4 weeks after treatment in HSP children treated with pure Chinese herbs and Chinese herbs with low molecular weight heparin were both decreased,and difference between the two groups was not significant(P>0.05).5.Blood AT-?activity was positively correlated with urine red blood cell count in children with HSPN,and urine PAI-1 / Cr was positively related to 24h-urine protein quantity.Conclusion 1.The high activity of AT-III could be associated with the occurrence of HSPN in children.2.The level of urine PAI-1 may be a good indicator of kidney injury.3.Children with HSP using the treatment of pure Chinese herbs and Chinese herbs combined with low molecular weight heparin both could improve blood coagulation state. |
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