目的观察舒洛地特对老年男性慢性肾病患者蛋白尿的影响。方法将122例伴有蛋白尿的老年男性非透析慢性肾脏病患者根据24h尿蛋白定量分为轻度蛋白尿(A组54例,0.3g≤24h尿蛋白定量〈1.5g),中度蛋白尿(B组40例,1.5g≤24h尿蛋白定量〈3.5g),大量蛋白尿(C组28例,24h尿蛋白定量≥3.5g)。3组患者在慢性肾脏病常规治疗基础上,均给予舒洛地特600LSU治疗,1/d,疗程20d。比较3组治疗前、后24h尿蛋白定量、血清肌酐、尿素氮、尿酸和凝血功能等指标变化。结果24h尿蛋白定量A组、B组治疗前、后比较,差异有统计学意义(P〈0.01),C组无显著变化(P〉0.05)。血清肌酐、尿素氮和尿酸3组治疗前、后比较,差异均无统计学意义(P〉0.05)。血浆凝血酶原时间、凝血酶时间、活化部分凝血酶原时间和纤维蛋白原3组患者治疗前、后比较,差异有统计学意义(P〈0.05)。结论舒洛地特可降低非大量蛋白尿的老年男性患者的慢性肾脏病尿蛋白水平及凝血功能,对肾功能无明显影响。
Objective To observe efficacy of sulodexide on proteinuria in elderly male patients with chronic kidney disease(CKD).Methods One hundred and twenty-two non-dialysis CKD elderly male patients were enrolled.They were divided into 3 groups according to the levels of 24h proteinuria: group A(0.3g≤24h proteinuria1.5g),group B(1.5g≤24h proteinuria3.5g) and group C(24h proteinuria≥3.5g).All groups were given routine treatment and sulodexide 600 LSU/d for 20 days.Quantization of 24h proteinuria,serum creatinine(Scr),blood urea nitrogen(Bun),uric acid(UA) and conventional blood coagulative parameters were analyzed in the three groups before and after treatment.Results In the group A and group B,the levels of 24h proteinuria were decreased significantly at the end of the treatment(P0.01).There were no changes in Scr,BUN and UA after 20 days treatment in all the three groups(P0.05).However the levels of prothrombin time(PT),thrombin time(TT)and activated partial thromboplastin time(APTT)were significantly increased(P0.01) and fibrinogen(FIB)was decreased(P0.05) at the end of the treatment in the three groups.Conclusions Sulodexide can lower level of proteinuria in elderly male CKD patients who are not macroproteinuria.There were no changes in renal function after treatment.