中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2011年
10期
1046-1049
,共4页
慢性阻塞性肺疾病%抗凝疗法%肺功能%凝血功能%纤维蛋白原%D-二聚体
慢性阻塞性肺疾病%抗凝療法%肺功能%凝血功能%纖維蛋白原%D-二聚體
만성조새성폐질병%항응요법%폐공능%응혈공능%섬유단백원%D-이취체
Chronic obstructive pulmonary disease%Anticoagulant therapy%Lung function%Coagulation%Fibrinogen%D-dimer
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,4100 U AXa/次,腹壁皮下注射1次/12 h.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.
目的 探討慢性阻塞性肺疾病(COPD)患者急性加重期應用低分子肝素鈣對患者的肺功能和凝血功能的榦預作用.方法 選擇我科2009至2010年住院的COPD急性加重期患者70例,按隨機原則分為對照組32例和抗凝組38例.對照組患者給予吸氧、抗感染、解痙平喘、止咳化痰治療,抗凝組在對照組常規治療的基礎上加用低分子肝素鈣,4100 U AXa/次,腹壁皮下註射1次/12 h.2組均10d為1箇療程.2組均于治療前後檢測肺功能和凝血功能.結果 治療後2組的肺功能及動脈血氣指標均顯著優于治療前(抗凝組:t =8.2064,6.9207,9.4351,7.5845,7.5241；對照組t=5.5588,3.0795,3.9374,2.8488,2.7726,P均＜0.01),但抗凝組改善程度顯著優于對照組(t=3.2732,4.0167,7.3392,2.2528,3.0008,P均＜0.01)；治療後抗凝組的D-D含量及凝血指標(INR、PT、APTT、FIB)改善均顯著優于治療前(t值分彆為5.721、23.235、25.318、23.841、11.354,P均＜0.01)和對照組(t值分彆為7.738、19.365、23.373、21.008、9.712,P均＜0.01),而對照組治療前後比較改善程度差異無統計學意義(P均＞0.05).抗凝組中無嚴重不良反應髮生.結論 常規治療雖能使COPD患者得到改善,但無法有效地改善患者血液的高凝狀態.常規治療聯閤低分子肝素鈣抗凝治療,在改善患者凝血功能同時能更好的改善患者的肺功能.
목적 탐토만성조새성폐질병(COPD)환자급성가중기응용저분자간소개대환자적폐공능화응혈공능적간예작용.방법 선택아과2009지2010년주원적COPD급성가중기환자70례,안수궤원칙분위대조조32례화항응조38례.대조조환자급여흡양、항감염、해경평천、지해화담치료,항응조재대조조상규치료적기출상가용저분자간소개,4100 U AXa/차,복벽피하주사1차/12 h.2조균10d위1개료정.2조균우치료전후검측폐공능화응혈공능.결과 치료후2조적폐공능급동맥혈기지표균현저우우치료전(항응조:t =8.2064,6.9207,9.4351,7.5845,7.5241；대조조t=5.5588,3.0795,3.9374,2.8488,2.7726,P균＜0.01),단항응조개선정도현저우우대조조(t=3.2732,4.0167,7.3392,2.2528,3.0008,P균＜0.01)；치료후항응조적D-D함량급응혈지표(INR、PT、APTT、FIB)개선균현저우우치료전(t치분별위5.721、23.235、25.318、23.841、11.354,P균＜0.01)화대조조(t치분별위7.738、19.365、23.373、21.008、9.712,P균＜0.01),이대조조치료전후비교개선정도차이무통계학의의(P균＞0.05).항응조중무엄중불량반응발생.결론 상규치료수능사COPD환자득도개선,단무법유효지개선환자혈액적고응상태.상규치료연합저분자간소개항응치료,재개선환자응혈공능동시능경호적개선환자적폐공능.
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 ＜ 0.01 ),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 =5.721,23.235,25.318,23.841,11.354,Pall ＜ 0.01 ; comparing 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.
