Anticoagulant Mechanism Of Indobufen In Idiopathic Membranous Nephropathy

Objectives To compare and analyze the changes of coagulation indexes,the amount of factor ? and factor X,clinical baseline data and laboratory test indexes before and after oral administration of indobufen and warfarin in patients with idiopathic membranous nephropathy(IMN).Observe the occurrence of adverse events such as thrombosis or embolism,hemorrhage to evaluate the effectiveness and safety of indobufen against thrombosis.Methods Forty-seven patients with IMN who were treated in the Hebei Provincial People's Hospital from January 2019 to October 2019 were included.All patients were treated with,methylprednisolone combined with cyclosporine.The included patients were divided into indobufen group(n=32)and warfarin group(n=15).The baseline data of the two groups of patients are comparable.In the indobufen group,patients were given 200 mg of indobufen orally twice daily.Warfarin group:Gave the initial dose of warfarin 2.5mg once a day orally,subcutaneous injection of overlapping low-molecular-weight heparin 5000IU once a day,adjust the dose according to the INR obtained from monitoring,and stop the low-molecular-weight heparin after maintaining the INR value between 2 and 3.Detect the coagulation indexes of patients before and 2 weeks after medication,including coagulation factor II,coagulation factor X,prothrombin time(PT),activated partial thromboplatin time(APTT),International Normalized Ratio(INR),fibrinogen(FIB),thrombin time(TT)and D-Dimer(D-Dimer).Observe the occurrence of adverse events such as thrombosis or embolism,hemorrhage,and abnormal liver and kidney function within 3 months of the anticoagulant treatment of the included patients.After 3 months,the patients was performed ultrasound examination of the double renal veins and deep veins of the lower extremities,clear the venous thrombosis.Results 1.After 2 weeks of treatment in the indobufen group,UTP,Alb and GLO had no significant changes(P>0.05),factor II,factor X,PT,APTT,INR,D-dimer and FIB decreased,TT increased compared with before the start of the treatment(P<0.05).2.After 2 weeks of warfarin treatment,UTP,Alb,and GLO had no significant changes(P>0.05),coagulation factor II,coagulation factor X,FIB and D-Dimer decreased(P<0.05),PT,APTT,INR and TT increased(P<0.05).3.After 2 weeks of medication,the factor II and factor X of the two groups of patients showed a downward trend,of which the warfarin group decreased more than the indobufen group,the difference was statistically significant(P<0.05).The PT and APTT of the indobufen group were shortened,and the PT and APTT of the warfarin group were significantly prolonged.There was a difference between the groups,and the difference before and after the warfarin group was more significant than that of the indobufen group.Statistical significance(P<0.05).The TT of the two groups of patients was prolonged,and there was no difference between the groups;the INR of the indobufen group showed a downward trend,while the INR of the warfarin group showed a significant upward trend,the difference was statistically significant(P<0.05).FIB and D-Dimer in both groups showed a downward trend,but there was no difference between the groups(P>0.05).4.There was no difference in the incidence of adverse reactions between the two groups of patients after 3 months of follow-up(P>0.05).Conclusions 1.Indobufen can effectively prevent thrombosis in patients with IMN2.Compared with warfarin,indobufen has less effect on PT and APTT,and the risk of bleeding has not increasedFigure[0];Table[11];Reference[144]...