Quellhorst E, Reichel W, Fernandez-Redo E, Scheler F
Med Klin. 1977 Jun 3;72(22):981-7.
32 patients with different histologically proven forms of glomerulonephritis were treated with heparin for an average of 31 days. A dosage of heparin was chosen, which allowed an increase in thrombin time to 20-40 seconds. Histological findings alone do not allow any prediction concerning the therapeutic success of heparin treatment in glomerulonephritis. According to our results and comparable information given in the literature, the following therapeutic scheme can be recommended: Best results are seen in patients with a slow decrease of GFR (i.e. less than 30 ml/min) during the year preceding the beginning of the treatment. In rapid progredient glomerulonephritis, however, as in patients without any changes of GFR during this time, predictions as to the course of illness cannot be made. A high level of fibrin split products in serum may be expected to be the most valuable sign of therapeutic effect, as could be documented in 7 out of 8 successfully treated patients. Hypertension and proteinuria were not influenced by the treatment. Because of severe side effects the heparin treatment of glomerulonephritis should not be initiated in patients with severe hypertension.
32例经组织学证实患有不同类型肾小球肾炎的患者接受了肝素治疗,平均治疗时间为31天。选择的肝素剂量能使凝血酶时间延长至20 - 40秒。仅组织学检查结果无法对肝素治疗肾小球肾炎的疗效作出任何预测。根据我们的研究结果以及文献中的相关信息,可推荐以下治疗方案:在治疗开始前一年肾小球滤过率(GFR)缓慢下降(即低于30毫升/分钟)的患者中,治疗效果最佳。然而,对于快速进展性肾小球肾炎患者,以及在此期间GFR无任何变化的患者,无法对疾病进程作出预测。血清中高水平的纤维蛋白降解产物可能是治疗效果最有价值的指标,8例治疗成功的患者中有7例证实了这一点。高血压和蛋白尿不受该治疗影响。由于严重的副作用,重度高血压患者不应开始肝素治疗肾小球肾炎。