PREVENTIVE VALUE
OF HEPARIN ON THE OCCURRENCE OF NEPHROPATHY IN HENOCH-SCHOENLEIN PURPURA: A
RANDOMIZED CONTROLLED CLINICAL TRIAL
He Yanyan, Song
Hongmei, Shao Lihua, Wei Min
Peking Union Medical
College Hospital, Beijing, China
Objective: To
evaluate the preventive value of heparin on the incidence of nephropathy in
the patients with Henoch-Schoenlein purpura (HSP).
Methods:
Two-hundred and twenty-eight patients with HSP were enrolled in the study
and divided randomly into two groups: heparin group (H) and control group
(C). In H group, 119 patients were administrated by sodium heparin with a
intravenous dose of 120~150 IU/kg · d for five days or by calcium heparin
with a hypodermic dose of 10 IU/kg · d for seven days at the onset or
relapse of HSP. Where as 109 patients received only vehicles in group C.
All patients were also medicated by other commonly used drugs such vitamin
C and vitamin P, and followed up for more than three months.
Results: The
incidence of nephritis was nine (8.2%) in H group and 30 (38.8%) in C group
respectively (p<0.0001). The occurrence of nephritis in H group was
significantly delayed than C group (81.8 ± 64.5 day vs. 34.5 ± 32.1 day,
p<0.01). The clinical characteristics of renal involvement consisted of
simple hematuria with two cases (22.2%) and 12 cases (40.0%), hematuria
plus proteinuria with six cases (66.7%) and 15 (50.0%), hematuria plus
nephrosis with one case (11.1%) and three cases (10.0%), in H and C groups,
respectively. No significant difference was observed. No severe side
effects such as bleeding were observed during the process of heparin
treatment.
Conclusion:
Heparin, which was safe and tolerant for patients, could significantly
reduce the incidence of HSP nephritis (HSPN) and may be a useful protectant
against the renal involvement among patients with HSP.