Wu J F, Wang S H
Zhonghua Nei Ke Za Zhi. 1989 Mar;28(3):171-3, 188.
When chronic glomerulonephritis (CGN) proceeds to chronic renal failure (CRF), there are decline of fibrinolytic activity and deposition of fibrin in glomeruli with resulting thromboembolic lesions. 46 CGN patients with complicating CRF were thus treated with defibrase made from viper venom. Defibrase in a dose of 0.025 unit/kg dissolved in 250 ml 10% glucose was infused slowly once every 3 days in a total of 6 times. After the treatment, BUN and serum creatinine levels decreased, creatinine cleance improved and the clinical manifestations of uremia alleviated or disappeared. In some patients there were increase of hemoglobin concentration and decrease of urinary protein excretion. Hypertension was controlled in 17 out of 20 patients treated in combination with captopril. Level of plasma fibrinogen was significantly reduced after defibrase administration, but the reduction was not related to the therapeutic effect. Urinary output was increased in most of the patients, being related to the therapeutic effect. The authors are of the opinion that renal function may be improved in CGN patients after defibrase treatment due probably to elimination of fibrin deposition and resolution of thromboembolic lesions in glomeruli. However, a suitable dose has to be determined as there is no effective way to monitor the most dreaded complication of defibrase therapy bleeding.
慢性肾小球肾炎（CGN）发展为慢性肾衰竭（CRF）时，纤溶活性下降，纤维蛋白在肾小球内沉积，导致血栓栓塞性病变。因此，对46例并发CRF的CGN患者用蝮蛇毒制成的去纤酶进行治疗。将剂量为0.025单位/千克的去纤酶溶解于250毫升10%葡萄糖中，每3天缓慢输注1次，共6次。治疗后，血尿素氮和血清肌酐水平下降，肌酐清除率提高，尿毒症的临床表现减轻或消失。部分患者血红蛋白浓度升高，尿蛋白排泄减少。20例联合卡托普利治疗的患者中，17例高血压得到控制。使用去纤酶后血浆纤维蛋白原水平显著降低，但降低与治疗效果无关。大多数患者尿量增加，与治疗效果有关。作者认为，去纤酶治疗后CGN患者的肾功能可能得到改善，这可能是由于纤维蛋白沉积的消除和肾小球血栓栓塞性病变的消退。然而，由于没有有效的方法监测去纤酶治疗最可怕的并发症出血，必须确定合适的剂量。
