Abstract
Objective This study aimed to explore the clinical efficacy and relevant mechanism of Tripterygium glycosides combined with low molecular weight heparin calcium (LMWH) in the treatment of Henoch–Schönlein purpura nephritis (HSPN) in children. Methods 64 cases of children patients with HSPN treated at Qilu Hospital (Qingdao) from January 2015 to May 2020 were selected and randomly divided into the control group and the observation group and 32 cases in each group. Conventional medical treatment was applied in the two groups, besides which the control group was given LMWH while the observation group was given Tripterygium glycosides based on the control group. The clinical efficacy and the indexes of clinical symptoms of the two groups were compared. Immune globulin level, fibrinogen content (FIB), prothrombin time (PT), platelet level (PLT), and activated partial thromboplastin time (APTT) level of the two groups were compared before and after the treatment. Results The total effective rate in the observation group was significantly higher than that of the control group, and the recurrence rate in the observation group was lower than that in the control group. After treatment, urine red blood cell count and 24 h urine protein were obviously better than those of the control group. There was no statistically significant difference in PT between the two groups of children before and after treatment. The levels of PLT and FIB in the two groups of patients after treatment were significantly lower than before treatment, and the PLT levels in the observation group were lower than those in the control group. Conclusion The combination of Tripterygium glycosides and LMWH had good clinical effects in the treatment of children with HSPN, and it could improve the clinical symptoms, the mechanism of which might be related to the increase of PT, a decrease of PLT, and the improvement of coagulation function.
Highlights
Henoch–Schonlein purpura (HSP) in children is a systemic inflammatory vascular disease mediated by immunoglobulin A. e clinical manifestations of children with HSP include skin purpura, arthritis, hemorrhagic gastroenteritis, and renal damage, and in some cases, manifest as asymptomatic urine abnormalities [1]
All children were followed up for one year, and it was found that 15 cases in the control group relapsed, while 4 cases in the observation group relapsed. e recurrence rate in the observation group was significantly lower than that in the control group (P < 0.05)
According to a survey on the spectrum of childhood glomerular diseases performed in China from 2004 to 2014, Henoch–Schonlein purpura nephritis (HSPN) (13%) and lupus nephritis (9%) are the most common secondary glomerular diseases in children
Summary
Henoch–Schonlein purpura (HSP) in children is a systemic inflammatory vascular disease mediated by immunoglobulin A. e clinical manifestations of children with HSP include skin purpura, arthritis, hemorrhagic gastroenteritis, and renal damage, and in some cases, manifest as asymptomatic urine abnormalities [1]. Kidney damage is a common secondary injury in HSP, with a higher incidence of Henoch–Schonlein purpura nephritis (HSPN), often transient hematuria, accompanied by varying degrees of renal disease and functional impairment [2, 3]. HSPN tends to occur in children under 10 years of age, and it accounts for about 8% of pediatric urinary system patients [4]. E incidence rate in boys is higher than that in girls [5]. Most of the children show self-limiting characteristics and can be cured within a few weeks after the onset. About one-half of the children still have recurrent attacks [6].
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