厄贝沙坦联合低分子肝素治疗慢性阻塞性肺疾病并肺动脉高压探讨

Investigation on irbesartan combined with low molecular weight heparin in the treatment of COPD patients with pulmonary hypertension

目的探讨厄贝沙坦联合低分子肝素治疗慢性阻塞性肺疾病（COPD）并肺动脉高压效果。方法COPD住院患者49例随机分为常规组22例，治疗组27例。常规组采用一般COPD常规治疗；治疗组加用厄贝沙坦80mg，1次／d，低分子肝素钠0．4ml腹部皮下注射，2次／d，连用14d。观察并比较两组肺动脉压力变化，血浆D-二聚体（DD）变化等情况。结果治疗后肺动脉压力明显降低，且两组治疗后差异有统计学意义（P〈0．01）。结论厄贝沙坦联合低分子肝素治疗COPD，能显著降低患者肺动脉压力。

Objective To evaluate the clinical effect,the changes of pulmonary hypertension, serum D-dimer and side effect of irbesartan combined with low molecular weight heparin in the treatment of pulmonary hypertension in COPD patients. Methods 49 patients of COPD were randomly allocated into two groups ： the control group （ n = 22） and the treatment group （ n =27 ）. The patients of the control group were treated with common treatments, for the treat- ment group, irbesartan 80rag qd combined with low molecular weight heparin 0.4ml IH bid were additionally administered for 14 days. To evaluate the clinical effect, the changes of pulmonary hypertension, serum D-dimer and side effects. Results The treatment group and the control group could reduce the pulmonary artery pressure. The clinical effects of the former were statistically significant better than the control（ P 〈 0. 01 ）. Side effect had no statistically significant difference between two groups. Conclusion Irbesartan combined with low molecular weight heparin have better clinical effects in the treatment of pulmonary hypertension in COPD patients and it was convenient, safe and worthy of extending in clinic.