低分子量肝素干预治疗重症急性胰腺炎及对TNF-α的影响

Low Molecular Weight Heparin Protects Severe Acute Pancreatitis Patients Via Lowering Tumor Necrosis Factor-α

目的探讨低分子量肝素(low molecular weight heparin,LMWH)干预治疗重症急性胰腺炎(severe acutepancreatitis,SAP)患者的疗效以及对患者外周血TNF-α的影响。方法将收治的40例SAP患者随即分为对照组和治疗组,对照组采用常规治疗方案,治疗组在常规治疗的基础上加用LMWH 100mg/kg,皮下注射,1次/12h,连续2周。比较两组患者的APACHE-II评分、治愈率、病死率、并发症以及外周血TNF-α水平。结果与对照组相比,治疗组治愈率明显提高(P<0.05),病死率明显下降(P<0.05),并发症明显减少(P<0.05),APACHE-II评分下降(P<0.05),TNF-α水平明显下降(P<0.05)。结论 LMWH通过减少炎症因子TNF-α,改善微循环障碍,缓解临床症状,缩短病程。

Objective To explore the therapeutic effects of low molecular weight heparin on severe acute pancreatitis （ SAP）. Methods All 40 cases of SAP randomLy divided into 2 groups. Control group （n=20） received conventional treatment. The treatment group （ n=20 ） received low molecular weight （ LMWH, 100mg/kg, once/12h, 2 weeks ） except conventional treatment. There was no significant difference between control group and the treatment group in ordinary conditions （ P 〈0.05 ）. Results 16 （ 80.0% ） out of 20 cases were cured and 4 （ 20.0% ） died in treatment group; 13 （ 65.0 % ） out of 20 cases were cured and 7 （ 35.0% ） died in control group. The therapeutic efficacy of treatment group was superior to control group, there was significant difference between two groups （ P 〈 0.05 ）. The APACHE-Ⅱ point in treatment group at the fourteenth day （ 0.09 ±.0.05 ） were significantly lower than the control group （ 0.19 ±0.08 ） （ P 〈 0.05 ）. Conclusion Low molecular weight heparin protects severe acute pancreatitis patients via lowering tumor necrosis factor- α levels.