低分子肝素治疗脓毒症疗效观察

Therapeutic Effect of Low Molecular Weight Heparin on Sepsis

目的:观察低分子肝素治疗脓毒症的临床疗效。方法:将60例脓毒症患者随机分成治疗组和对照组,每组30例。在相同常规治疗基础上,治疗组加用低分子肝素钙皮下注射,12h 1次,共7天。观察两组患者治疗前后急性生理学和慢性健康状况评分Ⅱ(APACHEⅡ),C反应蛋白(CRP)、降钙素原(PCT)、血小板计数(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)及纤维蛋白原(FIB)的变化;统计两组ICU住院时间和28天病死率。结果:治疗后7天,治疗组APACHEⅡ评分、CRP、PCT水平均低于对照组,差异有统计学意义(P<0.05);治疗组血小板计数高于对照组,差异有统计学意义(P<0.05);两组治疗后PT、APTT及FIB差异均无统计学意义(P>0.05);治疗组ICU住院时间和28天病死率比对照组降低,但两组比较差异无统计学意义(P>0.05)。结论:低分子肝素可降低脓毒症患者的炎症反应,改善患者凝血功能,并有缩短ICU住院时间、降低脓毒症患者病死率趋势,临床使用安全。

Objective： To observe the clinical efficacy of low molecular weight heparin in treatment of sepsis.Methods： Sixty sepsis patients were randomly divided into conventional treatment group and heparin group,30 in each.The heparin group was percutaneously injected with heparin twice a day for 7 days based on the conventional therapy in the control group.APACHE II was scored and C-reactive protein（CRP）,plasma calcitonin（PCT）,platelet（PLT）,prothrombin time（PT）,activated partial thromboplastin time（APTT）,and fibrinogen（FIB） were detected before and after treatment.Stay in ICU and 28-d mortality were calculated in both groups.Results： After treatment,compared with the control group,APACHE II scores and the levels of CRP and PCT were lower（P〈0.05）,PLT was higher（P〈0.05） in the heparin group,while the levels of PT,APTT,and FIB were the same between the 2 groups（P〈0.05）.Stay in ICU was shorter and the 28-day mortality was lower in the heparin group than those in the control group without a significant difference between them（P〈0.05）.Conclusion： Low molecular weight heparin can attenuate inflammation and improve coagulation in sepsis patients.This may result in reduction of stay in ICU and mortality.