摘要
目的探究在慢性阻塞性肺疾病急性加重期并肺炎患者中,应用抗凝治疗的临床效果及其对肺动脉压的影响。方法选取2022年5月—2024年9月在东莞市东南部中心医院呼吸科接受诊治的慢性阻塞性肺疾病急性加重期合并肺炎患者80例纳入研究,按治疗方案的不同将其划分成对照组(n=40)和抗凝组(n=40),对照组采用常规治疗方案,抗凝组采用常规治疗+低分子量肝素钙抗凝治疗,记录2种方案的实施效果,并通过比较凝血功能、动脉血气、肺功能及肺动脉收缩压(pulmonary artery systolic pressure,PASP)等指标的数据变化,分析抗凝治疗在此类患者中的应用价值。结果治疗后,抗凝组治疗总有效率为95.00%,对照组为77.50%,抗凝组高于对照组,差异有统计学意义(P<0.05);抗凝组的PASP水平为(27.43±8.11)mmHg,对照组为(36.98±11.13)mmHg,抗凝组低于对照组,差异有统计学意义(P<0.05);抗凝组的凝血酶原时间(prothrombin time,PT)和凝血酶时间(thrombin time,TT)分别为(16.60±2.21)s、(17.19±1.54)s,对照组分别为(13.49±2.11)s、(14.63±1.52)s,抗凝组长于对照组,抗凝组的纤维蛋白原(fibrinogen,Fbg)和D-二聚体(D-dimer,D-D)水平分别为(2.79±0.31)g/L、(233.58±45.79)μg/L,对照组分别为(3.33±0.43)g/L、(384.47±65.98)μg/L,抗凝组低于对照组,差异均有统计学意义(P<0.05);抗凝组的动脉血氧分压(arterial partial pressure of oxygen,PaO_(2))和动脉血二氧化碳分压(arterial partial pressure of carbon dioxide,PaCO_(2))分别为(90.22±4.58)mmHg、(36.12±3.41)mmHg,对照组分别为(84.29±6.13)mmHg、(39.48±3.31)mmHg,抗凝组高于对照组,差异均有统计学意义(P<0.05)。结论应用抗凝治疗慢性阻塞性肺疾病急性加重期并肺炎患者,能够在增强其凝血功能的同时,改善血气指标和肺动脉高压症状,并能更好地缓解患者症状。
Objective To investigate the clinical effect of anticoagulant therapy and its influence on pulmonary artery pressure in patients with acute exacerbation of chronic obstructive pulmonary disease complicated with pneumonia.Methods A total of 80 patients with acute exacerbation of chronic obstructive pulmonary disease complicated with pneumonia who received diagnosis and treatment in the department of Respiratory medicine,the Southeast General Hospital of Dongguan from May 2022 to September 2024 were included in the study.They were divided into a control group(n=40)and an anticoagulation group(n=40)according to different treatment regimens.The control group was given a conventional treatment regimen,while the anticoagulation group was treated with conventional treatment plus low-molecular-weight heparin calcium for anticoagulation.The implementation effects of the two regimens were recorded,and the application value of anticoagulant therapy in such patients was analyzed by comparing the changes in indicators such as coagulation function,arterial blood gas,pulmonary function,and pulmonary artery systolic pressure(PASP).Results After treatment,the total effective rate of the anticoagulation group was 95.00%,while that of the control group was 77.50%.The anticoagulation group had a higher total effective rate than the control group,with a statistically significant difference(P<0.05).The PASP in the anticoagulation group was(27.43±8.11)mmHg,compared with(36.98±11.13)mmHg in the control group.The PASP level in the anticoagulation group was lower than that in the control group,and the difference was statistically significant(P<0.05).In terms of coagulation function indicators,the prothrombin time(PT)and thrombin time(TT)in the anticoagulation group were(16.60±2.21)s and(17.19±1.54)s,respectively,while those in the control group were(13.49±2.11)s and(14.63±1.52)s,respectively.The PT and TT in the anticoagulation group were longer than those in the control group.The levels of fibrinogen(Fbg)and D-dimer(D-D)in the anticoagulation group were(2.79±0.31)g/L and(233.58±45.79)μg/L,respectively,compared with(3.33±0.43)g/L and(384.47±65.98)μg/L in the control group.The Fbg and D-D levels in the anticoagulation group were lower than those in the control group,with statistically significant differences in all these indicators(P<0.05).Regarding arterial blood gas indicators,the arterial partial pressure of oxygen(PaO_(2))and arterial partial pressure of carbon dioxide(PaCO_(2))in the anticoagulation group were(90.22±4.58)mmHg and(36.12±3.41)mmHg,respectively,while those in the control group were(84.29±6.13)mmHg and(39.48±3.31)mmHg,respectively.The PaO_(2)in the anticoagulation group was higher than that in the control group,and the PaCO_(2)was lower than that in the control group,with statistically significant differences in both indicators(P<0.05).Conclusion The application of anticoagulant therapy in patients with acute exacerbation of chronic obstructive pulmonary disease complicated with pneumonia can enhance their coagulation function,improve blood gas indicators and symptoms of pulmonary hypertension,and better relieve the patients'symptoms.
作者
郑祝权
罗伟辉
林镜宏
ZHENG Zhuquan;LUO Weihui;LIN Jinghong(Department of Respiratory Medicine,the Southeast General Hospital of Dongguan,Dongguan Guangdong 523000,China;Department of Gastroenterology,the Southeast General Hospital of Dongguan,Dongguan Guangdong 523000,China;Department of Oncology,the Southeast General Hospital of Dongguan,Dongguan Guangdong 523000,China)
出处
《中国卫生标准管理》
2025年第14期146-150,共5页
China Health Standard Management
基金
2022年东莞市社会发展科技项目(20221800903592)。
关键词
抗凝治疗
慢性阻塞性肺疾病
肺炎
呼吸系统疾病
肺动脉压
凝血酶原时间
anticoagulant therapy
chronic obstructive pulmonary disease
pneumonia
Respiratory diseases
pulmonary artery pressure
prothrombin time
