大剂量维生素E加超微量肝素对过敏性紫癜患儿氧化应激及微炎症状态的影响

摘要

Objective:To study the effects of high dose of vitamin E plus ultra-micro-heparin on oxi-dative stress and microinflammatory state in children with henoch-schonlein purpura. Methods:114 children with Henoch-Schonlein purpura were enrolled in this study from August 2012 to January 2016. All children were divided into control group(n = 57 cases) and study group(n = 57 cases) according to the digital table method. The control group of children with conventional treatment of allergic purpura method,the study group of children in the control group based on the use of large doses of vitamin E and ultra-micro heparin. Results:After treatment,all the indexes of the study group decreased significantly (P <0.05), and there was signifi-cant difference between the two groups (P <0.05). All patients had no obvious abnormality of coagulation time,bleeding time and platelet count before and after treatment,and all children treated with heparin had no severe allergic reaction and side effects.All the children's blood lipids,Hb,ALB,etc.were no significant ab-normalities,all large doses of vitamin E in children with no significant thrombosis, bleeding and other side effects. The total effective rate in the control group was 78.9%,significantly lower than the total effective rate of the study group was 96.5%(P <0.05).In the control group,14 out of 57 patients had nephritis and the in-cidence of HSPN was 24.6%. In the study group,4 patients had nephritis,and the incidence of HSPN was 7. 0%. The incidence of HSPN in the control group was significantly higher than that in the study group(χ2= 5. 377, P <0.05).Conclusion:The synergistic effect of ultra-micro-heparin plus high dose of vitamin E on dif-ferent pathogenesis of HSP can significantly reduce the incidence of HSP nephropathy and improve the micro-inflammatory state and oxidative stress state of HSP.%目的:研究大剂量维生素 E 加超微量肝素对过敏性紫癜患儿氧化应激及微炎症状态的影响.方法:选取2012年8月至2016年1月共114例过敏性紫癜患儿作为研究对象.按照数字表法将所有患儿分为对照组(n=57例)和研究组(n=57例).其中对照组患儿采用常规治疗过敏性紫癜方法,研究组患儿在对照组基础上加用大剂量维生素 E 和超微量肝素.结果:治疗前对照组免疫应激指标和炎症指标与研究组对比均无统计学差异(P>0.05),治疗后,研究组 MDA 和 AOPP 显著降低,SOD和GSH-PX明显升高,且均具有统计学差异(P<0.05),与对照组有显著性差异(P<0.05).治疗后,研究组各项指标均明显下降,且均具有统计学差异(P<0.05),与对照组有显著性差异(P<0.05).所有患儿治疗前后的凝血时间、出血时间和血小板计数均未见明显异常,所有进行肝素治疗的患儿均未见严重的过敏反应和毒副作用.所有患儿的血脂、Hb、ALB等均未见明显异常,所有进行大剂量维生素E 的患儿均未见明显血栓、出血等副作用.对照组患儿总有效率为78.9%,明显低于研究组总有效率为96.5%(P<0.05).对照组57例患儿中有14例发生肾炎,HSPN 发生率为24.6%,研究组57例患儿中有4例发生肾炎,HSPN发生率为7.0%.对照组HSPN发生率明显高于研究组,且有统计学差异(χ2=5.377,P<0.05).结论:超微量肝素加大剂量维生素 E 对 HSP 不同致病环节的协同作用可明显减少 HSP 肾脏损害的发生率,明显改善HSP 的微炎症状态和氧化应激状态.