摘要
目的探讨慢性阻塞性肺疾病（COPD）患者急性加重期应用低分子肝素钙对患者的肺功能和凝血功能的干预作用。方法选择我科2009至2010年住院的COPD急性加重期患者70例，按随机原则分为对照组32例和抗凝组38例。对照组患者给予吸氧、抗感染、解痉平喘、止咳化痰治疗，抗凝组在对照组常规治疗的基础上加用低分子肝素钙，4100UAXa／次，腹壁皮下注射1次／12h。2组均10d为1个疗程。2组均于治疗前后检测肺功能和凝血功能。结果治疗后2组的肺功能及动脉血气指标均显著优于治疗前（抗凝组：t=8．2064，6．9207，9．4351，7．5845，7．5241；对照组t=5．5588，3．0795，3．9374，2．8488，2．7726，P均〈0．01），但抗凝组改善程度显著优于对照组（t=3．2732，4．0167，7．3392，2．2528，3．0008，P均〈0．01）；治疗后抗凝组的D—D含量及凝血指标（INR、PT、APTT、FIB）改善均显著优于治疗前（t值分别为5．721、23．235、25．318、23．841、11．354，P均〈0．01）和对照组（t值分别为7．738、19．365、23．373、21．008、9．712，P均〈0．01），而对照组治疗前后比较改善程度差异无统计学意义（P均〉0．05）。抗凝组中无严重不良反应发生。结论常规治疗虽能使COPD患者得到改善，但无法有效地改善患者血液的高凝状态。常规治疗联合低分子肝素钙抗凝治疗，在改善患者凝血功能同时能更好的改善患者的肺功能。
Objective To investigate the intervention of low molecular weight heparin on lung function and coagulation function of patients experiencing acute exacerbation of chronic obstructive pulmonary disease （COPD） .Methods Senventy patients, hospitalized in our department from 2009 -2010, with acute exacerbation of COPD, were randomly divided into control group （32 patients） and anticoagulation group （38 patients）. The control group was treated with oxygen inhalation, antibiotics, antispasmodic asthma, relieving cough and phlegm. The anticoagulation group received low molecular weight heparin 4100 IU AXa/times by abdominal subcutaneous injection at 12 h intervals addition to that of control group. Ten days were considered as a course of treatment in both groups. All patients received pulmonary function and blood coagulation testing before and after treatment. Results After treatment, lung function and arterial blood gas indices were significantly improved in both groups（ the anticoagulation group： t = 8. 2064,6. 9207,9. 4351,7. 5845,7. 5241 ; the control group t = 5. 5588,3.0795,3.9374,2. 8488,2. 7726, all P 〈 O. 01 ）, but the patients in anticoagulation group were improved more significantly than the control group（t = 3. 2732 4. 0167,7. 3392,2. 2528,3.0008 ,Pall 〈0. 01 ） ; anticoagulation treatment greatly improved the plasma D-dimer （D-dimer, DD） content and the coagulation parameters in anticoagulation group（ comparing with that before treatment,t = 5. 721,23. 235,25. 318,23. 841, 1 1. 354.Pall 〈 0. 01 ： comoaring with that of control, t = 7.738,19. 365,23. 373,21. 008.9. 712, Pall 〈 0. 01 ）,while the control group did not produce significant improvement after treatment （t = 1. 9409,8. 0000,1. 1592, 1. 6562,1. 2726, P all 〉 0. 05 ）. There were had no serious adverse reactions in the anticoagulation treatment group. Conclusion Although the conventional treatment can improve the symptoms of the patients with COPD, but it can＇t effectively improve the patient＇s blood hypercoagulability. Conventional therapy combined with low molecular weight heparin anticoagulant therapy is able to improve the blood coagulation hence the lung function in COPD patients.
出处
《中国综合临床》
2011年第10期1046-1049,共4页
Clinical Medicine of China
