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目的：评价肝素及藻酸双酯钠治疗儿童难治性肾病综合征（ＮＳ）的远期疗效。方法：在常规治疗的基础上，对Ａ组（治疗组）４７ 例患儿加用肝素钙５０ｕ／ｋｇ·ｄ 静滴（２４±１２．５）天，停药后用藻酸双酯钠（２～５）ｍ ｇ／ｋｇ·ｄ 口服（２６±１０．７）个月；同期未用肝素及藻酸双酯钠的３０ 例为Ｂ组（对照组）。观察两组患儿治疗前后的尿纤维蛋白降解产物（ＦＤＰ）、血液粘度指标（血液流变学、血脂）变化，并观察随访（１．５～６．５）年。结果：远期疗效达完全缓解者Ａ组４０ 例（８５．１１％ ），Ｂ组１６ 例（５３．３３％ ），其中复发者Ａ 组４ 例（１０％ ），Ｂ组１２ 例（７５％ ），Ａ组显著优于Ｂ组（Ｐ＜ ０．０１，＜ ０．００１）。治疗后尿ＦＤＰ水平Ａ组显著低于Ｂ组（Ｐ＜ ０．００１），完全缓解者显著低于部分缓解者（Ｐ＜ ０．００１）。治疗后的血液粘度指标Ａ组也显著低于Ｂ组。结论：用肝素及藻酸双酯钠治疗难治性ＮＳ患儿，可提高缓解率、降低复发率，而且治疗后ＦＤＰ有明显减低者，远期疗效较好。
Objective: To evaluate the long-term efficacy of heparin and sodium alginate in the treatment of childhood refractory nephrotic syndrome (NS). Methods: On the basis of routine treatment, 47 children in group A (treatment group) were treated with intravenous infusion of heparin 50u / kg · d intravenously (24 ± 12.5 days). After discontinuation of treatment, sodium alginate ( 2 ~ 5) m g / kg · d oral (26 ± 10.7) months; the same period without heparin and sodium alginate in 30 cases for the B group (control group). The changes of urinary fibrin degradation products (FDP) and blood viscosity index (hemorheology, blood lipid) before and after treatment in both groups were observed and followed up (1.5-6.5) years. Results: 40 cases (85.11%) in group A and 16 cases (53.33%) in group B received complete remission. Among them, 4 cases (10%) in group A and 12 cases (75% ), Group A was significantly better than group B (P <0.01, <0.001). After treatment, the urinary FDP level in group A was significantly lower than that in group B (P <0.001), and those in complete remission were significantly lower than those in partial remission (P <0.001). After treatment, the blood viscosity index A group was also significantly lower than the B group. Conclusion: Treatment of children with refractory NS with heparin and sodium alginate could improve the remission rate and reduce the recurrence rate. And after treatment, the FDP was significantly decreased, and the long-term curative effect was better.