Article(id=1292130250037687040, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292130221843571059, articleNumber=null, orderNo=null, doi=10.13699/j.cnki.1001-6821.2026.08.010, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1747929600000, receivedDateStr=2025-05-23, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1785997458227, onlineDateStr=2026-08-06, pubDate=1777305600000, pubDateStr=2026-04-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1785997458227, onlineIssueDateStr=2026-08-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1785997458227, creator=13701087609, updateTime=1785997458227, updator=13701087609, issue=Issue{id=1292130221843571059, tenantId=1146029695717560320, journalId=1246415772164075586, year='2026', volume='42', issue='8', pageStart='1051', pageEnd='1200', issueExtLink='null', onlineDate='null', pubDate='1777305600000', pubDateStr='2026-04-28', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1785997451505, creator='13701087609', updateTime=1786014411018, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1292201355276480844, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292130221843571059, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1292201355276480845, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292130221843571059, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1107, endPage=1113, ext={EN=ArticleExt(id=1292130250482283265, articleId=1292130250037687040, tenantId=1146029695717560320, journalId=1246415772164075586, language=EN, title=Clinical trial of low molecular weight heparin combined with cimetidine in the treatment of recurrent Henoch-Schönlein purpura in children, columnId=1246531407326105792, journalTitle=Chinese Journal of Clinical Pharmacology, columnName=Clinical and Basic Bridging Research, runingTitle=null, highlight=null, articleAbstract=
Objective To observe the clinical efficacy and safety of low molecular weight heparin (LMWH) calcium injection combined with cimetidine (CIM) injection in the treatment of children with recurrent Henoch-Schönlein purpura (HSP).
Methods Children with recurrent HSP were randomly divided into control group and treatment group. Both groups received conventional comprehensive treatment. The control group was administered 10 mg·kg-1 of CIM injection for intravenous infusion, bid. The treatment group received subcutaneous injection of 100 IU·kg-1 LMWH calcium injection in addition to control group’s regimen, qd. Both groups underwent continuous treatment for 14 days. Clinical efficacy, renal injury indicators, coagulation function parameters, immunoglobulin levels, T lymphocyte counts and inflammatory response markers were compared between the two groups, along with safety evaluation.
Results This clinical trial enrolled a total of 92 pediatric patients, with 46 cases each group. After treatment, the overall response rates were 78.26% (36 case/46 case) in control group and 93.48% (43 case /46 case) in treatment group; the urinary microalbumin (mALB) levels were (26.43±2.37) and (25.31±1.82) mg·L-1, respectively; urinary α1-microglobulin (α1-MG) levels were (10.23±1.22) and (9.58±1.25) mg·L-1, respectively; N-acetyl-β-D-glucosaminidase (NAG) levels were (16.32±1.12) and (15.70±1.18) U·L-1, respectively; cystatin C (CysC) levels were (0.77±0.19) and (0.69±0.13) mg·L-1, respectively; plasma D-dimer (D-Dimer) levels were (167.49±25.27) and (157.35±22.80) ng·mL-1, respectively; fibrinogen (FIB) levels were (3.19±0.87) and (2.81±0.48) g·L-1, respectively; prothrombin time (PT) were (11.44±1.19) and (12.17±1.52) s, respectively; the activated partial thromboplastin time (APTT) were (28.76±4.49) and (30.90±3.62) s, respectively; immunoglobulin A (IgA) levels were (2.35±0.56) and (2.08±0.59) g·L-1, respectively; IgE levels were (74.74±9.64) and (71.04±7.78) IU·L-1, respectively; IgG levels were (10.61±1.77) and (10.63±1.61) g·L-1, respectively; IgM levels were (1.31±0.28) and (1.29±0.26) g·L-1, respectively; CD4-positive T lymphocyte (CD4+) percentage were (37.89±4.92)% and (40.86±6.02)%, respectively; CD8+ percentage were (26.22±3.28)% and (24.55±3.01)%, respectively; CD4+/CD8+ ratio were 1.54±0.50 and 1.77±0.55, respectively; interferon-γ (IFN-γ) levels were (15.33±3.81) and (13.48±3.60) pg·mL-1, respectively; interleukin-4 (IL-4) levels were (27.38±4.07) and (25.33±3.47) pg·mL-1, respectively; interleukin-17 (IL-17) levels were (80.98±8.12) and (76.60±8.06) ng·L-1, respectively. All these parameters in treatment group showed statistically significant differences compared to control group (P<0.05, P<0.01). The main adverse drug reactions in treatment group included injection site redness and swelling, fatigue and vomiting, while those in control group included nausea, dizziness and vomiting. The overall incidence of adverse drug reactions was 6.52% (3 cases/46 cases) in control group and 8.70% (4 cases/46 cases) in treatment group, with no statistically significant difference between the two groups (P>0.05).
Conclusion The combination of LMWH calcium injections and CIM injections demonstrates superior efficacy in treating recurrent HSP in children, alleviating immune stress, exerting anti-inflammatory effects, and exhibiting safety profiles.
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目的 观察低分子肝素（LMWH）钙注射液联合西咪替丁（CIM）注射液治疗对儿童反复发作性过敏性紫癜（HSP）患儿的临床疗效及安全性。
方法 将反复发作性HSP患儿随机分为对照组与试验组。2组均给予常规综合治疗。对照组给予10 mg·kg-1 CIM注射液静脉滴注，bid。试验组在对照组基础上给予皮下注射100 IU·kg-1 LMWH钙注射液，qd。2组均连续治疗14 d。比较2组的临床疗效、肾损伤指标、凝血功能指标、免疫球蛋白指标、T淋巴细胞指标和炎症反应指标，并进行安全性评价。
结果 本研究共纳入92例患儿，对照组和试验组各纳入46例。治疗后，对照组和试验组的临床总有效率分别为78.26%（36例/46例）和93.48%（43例/46例）；尿微量白蛋白（mALB）分别为（26.43±2.37）和（25.31±1.82）mg·L-1；尿α1-微球蛋白（α1-MG）分别为（10.23±1.22）和（9.58±1.25）mg·L-1；N-乙酰-β-D-氨基葡萄糖苷酶（NAG）分别为（16.32±1.12）和（15.70±1.18）U·L-1；胱抑素C（CysC）分别为（0.77±0.19）和（0.69±0.13）mg·L-1；血浆D二聚体（D-Dimer）分别为（167.49±25.27）和（157.35±22.80）ng·mL-1；纤维蛋白原（FIB）分别为（3.19±0.87）和（2.81±0.48）g·L-1；凝血酶原时间（PT）分别为（11.44±1.19）和（12.17±1.52）s；凝血活酶时间（APTT）分别为（28.76±4.49）和（30.90±3.62）s；免疫球蛋白A（IgA）分别为（2.35±0.56）和（2.08±0.59）g·L-1；IgE分别为（74.74±9.64）和（71.04±7.78）IU·L-1； IgG分别为（10.61±1.77）和（10.63±1.61）g·L-1；IgM分别为（1.31±0.28）和（1.29±0.26）g·L-1；CD4阳性T淋巴细胞（CD4+）分别为（37.89±4.92）%和（40.86±6.02）%，CD8+分别为（26.22±3.28）%和（24.55±3.01）%；CD4+/CD8+分别为1.54±0.50和1.77±0.55；干扰素-γ（IFN-γ）分别为（15.33±3.81）和（13.48±3.60）pg·mL-1；白细胞介素-4（IL-4）分别为（27.38±4.07）和（25.33±3.47）pg·mL-1；IL-17分别为（80.98±8.12）和（76.60±8.06）ng·L-1，试验组的上述指标与对照组比较，在统计学上差异均有统计学意义（P<0.05，P<0.01）。对照组的药物不良反应包括恶心、头晕和呕吐；试验组的药物不良反包括注射部位红肿、乏力和呕吐。对照组和试验组药物不良反应总发生率分别为6.52%（3例/46例）和8.70%（4例/46例），在统计学上差异无统计学意义（P>0.05）。
结论 LMWH钙注射液联合CIM注射液治疗儿童反复发作性HSP疗效更佳，可减轻机体免疫应激，发挥抗炎作用，且具有安全性。
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张林（1979-），女，副主任医师，主要从事肾内风湿方面的临床工作和研究
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