Department of Renal Immunology, Children's Hospital of Soochow University, Soochow, JiangSu, China.
Department of Pediatrics, Zibo Maternal and Child Health Hospital, Zibo ShanDong, China.
BMC Nephrol. 2024 Feb 26;25(1):68. doi: 10.1186/s12882-024-03502-4.
To analyze the clinical effect of urokinase on the prevention of thrombosis in children with primary nephrotic syndrome.
A total of 370 children diagnosed with primary nephrotic syndrome (PNS) in the Children's Hospital of Soochow University and Zibo Maternal and Child Health Hospital from January 2018 to December 2022 were selected as the research objects. The patients were divided into a urokinase adjuvant therapy group and non-urokinase adjuvant therapy group according to the application of drugs. The clinical data of the children were collected, including sex, age, drug application, bleeding during treatment, and telephone follow-up, to record whether thromboembolism occurred in the acute stage and remission stage. The clinical pattern of PNS, renal biopsy, histopathological type, and related laboratory indexes before and after treatment were recorded.
A total of 313 patients were treated with urokinase and 57 patients were not. More thrombotic events was observed in non-urokinase group compared to the urokinase group(2 versus 0 episodes, p = 0.02). The thrombotic events observed included one patient had pulmonary embolism combined with right ventricular thrombosis, and another had intracranial venous thrombosis. More minor bleeding events occurred in urokinase group compared to the non-urokinase group(7 versus 1 episodes, p = 1.0). No major bleeding events occurred in either group.
The rational prophylactic use of urokinase anticoagulation in children with PNS can prevent the formation of thromboembolism and has good safety.
分析尿激酶预防原发性肾病综合征患儿血栓形成的临床效果。
选取 2018 年 1 月至 2022 年 12 月苏州大学附属儿童医院和淄博市妇幼保健院收治的原发性肾病综合征（PNS）患儿 370 例为研究对象。根据药物应用情况将患儿分为尿激酶辅助治疗组和非尿激酶辅助治疗组。收集患儿的临床资料，包括性别、年龄、药物应用、治疗期间出血情况和电话随访，记录患儿在急性期和缓解期是否发生血栓栓塞事件。记录 PNS 临床类型、肾活检、组织病理学类型及治疗前后相关实验室指标。
共 313 例患儿应用尿激酶，57 例患儿未应用。非尿激酶组血栓事件发生率高于尿激酶组（2 例与 0 例，p=0.02）。观察到的血栓事件包括 1 例合并肺栓塞和右心室血栓形成，另 1 例发生颅内静脉血栓形成。尿激酶组较非尿激酶组轻微出血事件发生率高（7 例与 1 例，p=1.0）。两组均未发生严重出血事件。
合理预防性应用尿激酶抗凝可预防 PNS 患儿血栓形成，且安全性良好。
