摘要
目的探讨重症监护病房高危静脉血栓患者炎性指标和纤维蛋白原、D-二聚体关系及防治措施。方法对128例重症监护病房高危静脉血栓患者（实验组）和65例正常对照者（对照组）分别进行高敏-C反应蛋白和纤维蛋白原、D-二聚体检测;应用肝素（5000U,每天3次,静脉注射）或低分子量肝素（100U/kg,皮下注射）,华发林（2～3mg,口服）,5d前后检测上述指标变化。结果实验组的高敏C-反应蛋白、纤维蛋白原、D-二聚体高于对照组,差异具有统计学意义（P〈0.05～0.01）;应用肝素、低分子量肝素或华发林后,上述指标显著性降低（P〈0.05或〈0.01）。结论重症监护病房高危静脉血栓患者存在明显的高凝状态,采用抗凝尤其是低分子肝素可改善血液流变学、降低血液黏度,高敏C反应蛋白、纤维蛋白原和D-二聚体可作为抗凝的有效指标。
Objective To detect the changes of inflammatory factor, fibroblast and D-dimer, and prevention measures for patients with high risk factors of venous thromboembolism （VTE）. Method Hemorheological parameters include high sensitive C-reactive protein （hs-CRP）, fibroblast, and D-dimer were determined in 128 patients with high risk factors of VTE （experimental group） at intensive care unit and 65 healthy subiects （control group）. These parameters were checked after heparin, low molecular weight heparin （LMWH） and warfarin in patients high risk factors of VTE. Results Compared with the control groups, hs-CRP, fibroblast and D-dimer in patients with high risk of VTE has significant difference （ P 〈 0.05 or 0.01 ） ; these parameters were decreased significantly after effective anti-coagulation therapy （ P 〈 0.05 or 〈 0.01 ）. Conclusions There were obvious hemorheological changes and microcirculation disorder in patients with VTE. It is reasonable to use anti-coagulants such as LMWH to improve microcireulation and to take blood viscosity, and levels of hs-CRP, fiboblast and D-dimer as important indices during the monitoring of VTE formation .
出处
《中华急诊医学杂志》
CAS
CSCD
2007年第8期848-850,共3页
Chinese Journal of Emergency Medicine
关键词
重症监护病房
静脉血栓栓塞症
血液流变学
抗凝
低分子肝素
Intensive Care Unit （ICU）
Venous thromboernbolism （VTE）
Hemorheology
Anticoagulation
Low molecular weight heparin （LWMH）
