低分子肝素佐治充血性心力衰竭的临床研究

Low Molecular Weight Heparin Hyperemia of Observation

目的探讨低分子肝素对充血性心力衰竭患者心功能、凝血功能的影响。方法将62例慢性心力衰竭患者随机分为两组,对照组31例给予强心、利尿、扩血管、β受体阻滞剂、血管紧张素转换酶抑制剂、醛固酮受体拮抗剂等常规治疗;治疗组31例在此基础上加用低分子肝素5000U次/皮下注射,2次/d,共15d,2周后检查心脏超声,评估心功能、测定血浆D-二聚体,血浆纤维蛋白原水平。结果两组治疗后左室舒张末径(LVEDd)水平明显降低,左室射血分数(LVEF)水平明显升高,与治疗前比较差异有统计学意义(P<0.05);并且治疗组治疗后LVEDd、LVEF水平改善明显优于对照组,两组比较差异有统计学意义(P<0.05);治疗组血浆D-二聚体、血浆纤维蛋白原(FPG)水平明显降低(P<0.05)。结论低分予肝素既能降低血浆D-dime、rFPG水平,又可改善充血性心力衰竭心脏功能,有益于充血性心力衰竭的治疗。

Objective To explore low molecular weight heparin on cardiac function and coagulation function of patient with chronic heart failure, Methods 62 cases of chronic heart failure patients randomly divided into 2 groups, control group 31 cases give strong hear, diuretic, vasodilator, β - blockers, angiotensin - converting enzyme inhibitor and aldosterone receptor antagonists and other conventional therapy; therapy group 31 cases in a given low molecular weight heparin 5000U/subcutaneous injection, 2 times/day, a total of 15 days, 2 weeks after check echocardiographic assessment of cardiac function, determination of serum d - dimer, Fibrinogea level. Results Two groups of treated and left ventricular end - diastolic diameter （ LVEDd ） level is significantly lower, left ventricular ejection fi＇action （LVEF） level is significantly elevated, and comparing the differences before the treatment, a statistical significance （ P 〈 0. 05 ） ; and treatment group therapy to improve the level of LVEF LVEDd, than the control group, there are differences between the two groups compared statistically （ P 〈0. 05） ; treatment, serum d -dimer, plasma fibrinogen （FPG） level is significantly lower （ P 〈 0. 05 ）. Conclusion Low to heparin plasma lowers D - dimer, FPG level, but also to improve cardiac function in patients with congestive heart failure, useful and the treatment of congestive heart failure.