各種腎炎に対するheparinの効果　低補体性慢性糸球体腎炎を中心にして

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タイトル別名
  • Heparin therapy in varioustypes of nephritis Takao Kosaka
  • カクシュ ジンエン ニ タイスル heparin ノ コウカ テイ ホタイセイ

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This paper presents the results of a total of 18 courses of heparin therapy in 7 cases consisting of 5 membranoprolaferative glomerulonephritis (MPGN), 1 lupus nephritis, and 1 rapidly progressive glomerulonephritis (RPGN). Heparin proved markedly effective in one mild case of hypocomple mentemic MPGN and 1 case of RPGN, while moderately good response was obtained in 3 other patients with MPGN and was of no benefit for lupus nephritis and lobular MPGN. Upon assessing heparin's effectiveness the following 5 effects were examined, i.e., antiinflamm matory, anticoagulant, anticomplementary, antilipemic and diuretic effects. During 8 out of 15 heparin courses the decreases in FDP were noted. GFR as well as urine protein excretion impro-ved in the patients whose serum FDP levels fell by greater than 40μg/ml. The elevation of complement levels, which was directly related to the inhibiting action of heparin on C3 proacivator covertase, was observed in 3 patients. This anticomplementary effect took place through inhibition of activation of alternate pathway via NeF only in the patients with low complement activity. Antilipemic effect manifested itself as a lowering effect on triglyceride in the patients who had PHDA (post heparin lipolytic activity) levels above 1.5 mEq FFA/ml/h. It appears that therapy should be continued for more than 4 weeks and the dosage needed to produce optimal therapeutic effect with minimal untoward effects is 500-1500 U/kg/day by drip infusion method.

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