摘要:目的:探討肝素在預防過敏性紫癜性腎炎中的療效及安全性。方法:采用隨機對照的方法,將98例過敏性紫癜患兒分為肝素治療組(49例)和對照組(49例),肝素組給予肝素鈉100～150 Ｕ加入5%葡萄糖100～200 mL中靜脈點滴,每日1次,連用5～7天,以后每兩周查尿常規1次,至少觀察3個月或以上。結果:肝素治療組發生腎炎3例(6.1%),對照組發生腎炎11例(22.4%),肝素治療組腎炎發生率低于對照組(0.01lt;P≤0.05)。結論:肝素對預防紫癜性腎炎的發生有效,且不良反應少。Abstract: Objective: To investigate the heparin in the prevention of allergic purpura nephritis in the efficacy and safety. Methods:A randomizedcontrolled method, 98 cases of allergic purpura patients were divided into heparin in the treatment group (49 cases) and control group (49 cases), heparin group received heparin, 100150 u in 5% glucose 100 ~ 200 mL in the intravenous drip, day 1, used in conjunction 57 days, after a routine urine check every two weeks times, at least for 3 months or more.Results: The results of heparin treatment group occurred nephritis in 3 cases (6.1%), glomerulonephritis in 11 cases in control group (22.4%), glomerulonephritis incidence of heparin in the treatment group than the control group (0.01lt;P ≤ 0.05). Conclusion: heparin in preventing the occurrence of HenochSchonlein purpura nephritis and effective, and less adverse reactions.
ObjectiveTo systematically review the efficacy and safety of mycophenolate mofetil (MMF) for Henoch-Schonlein purpura nephritis (HSPN). MethodsDatabases such as PubMed, EMbase, CENTRAL, VIP, CNKI, CBM and WanFang Data were electronically searched for comprehensively collecting the randomized controlled trials (RCTs) on the efficacy and safety of MMF for HSPN from inception to December, 2013. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the methodological quality of the included studies. Then meta-analysis was performed using RevMan 5.1 software. ResultsA total of 10 RCTs involving 426 patients (231 in the trial group and 195 in the control group) were included. The trial group was treated with MMF and corticosteroids, and the control group was treated with corticosteroids monotherapy or combined with cyclophosphamide (CTX), leflunomide (LEF), or azathioprine (AZA). The results of meta-analysis showed that, as for efficacy, no significant difference was found between the two groups after six-mouth treatment (OR=1.36, 95%CI 0.67 to 2.73, P=0.85), while after twelve-mouth treatment, MMF was superior to CTX with a significant difference (OR=6.58, 95%CI 2.45 to 17.33, P=0.002). In addition, the efficacy of MMF was still superior to the azathioprine group, but not better than either LEF or prednisone monotherapy. Lower incidence of side effects were found in the MMF group, compared with the CTX group (OR=0.25, 95%CI 0.13 to 0.45, P < 0.000 01) and the prednisone monotherapy group (OR=0.26, 95%CI, 0.09 to 0.79, P=0.02), while there was no significant difference between the MMF group and the LEF group in side effects. ConclusionBased on the current evidence, the efficacy of MMF for HSPN is better than CTX, and its side effects are less than those of CTX and prednisone.