丹参制剂对关节置换患者术后凝血功能及D-二聚体的影响

The influence of Salvia miltiorrhiza agents on coagulant function and the d-dimer of joint replacement surgery patients

目的:观察丹参制剂对关节置换患者凝血功能及D-二聚体的影响,初步探讨丹参制剂预防深静脉血栓的作用机制。方法:将40例符合纳入标准患者随机分为对照组和治疗组各20例,两组术后均给予常规基础治疗,治疗组从术前1 d开始使用丹参注射液静脉滴注,术后第7天结束,术后第8天开始口服复方丹参滴丸,至术后第14天结束。对照组予皮下注射低分子肝素钙。观察两组患者凝血功能及D-二聚体的变化。结果:治疗组患者血浆凝血酶原时间、血浆活化部分凝血活酶时间、纤维蛋白以及D-二聚体较治疗前有明显改善,差异有统计学意义(P<0.05)。治疗组治疗后在凝血功能指标改善方面,与对照组比较,差异无统计学意义(P>0.05),但D-二聚体下降明显,差异有统计学意义(P<0.05),结论:丹参制剂可改善关节置换手术患者的血液高凝状态,具有抗血栓和降低D-二聚体作用,可能为丹参制剂预防关节置换术后深静脉血栓作用机制之一。

Purpose： Observation of joint replacement patients during operation period the use of Salvia mihiorrhiza on blood coagulation function and blood rheology,Preliminary study of Salvia miltiorrhiza preparation for preventing deep venous thrombosis mechanism of action. Methods： 40 patients were randomly divided into control group and treatment group, the treat- ment group patients from preoperative day started with Salvia mihiorrhiza injection （Zhengda Qingchunbao Pharmaceutical Com- pany Limited, specifications： 250 mL/bottle）Intravenous infusion, 250 mL/time, 2 times/day, seventh days after the end of.From the eighth postoperative day oral compound Danshen Drop Pills （Tianjin Tasly pharmaceutical limited company, specifications： 270 mg/particle） 270 mg/time, 3 times/day, after fourteenth days to end. Control group 12 hours before surgery, after 12 hours and 24 hours of the subcutaneous injection of low molecular heparin calcium for medicine （Tianjin GlaxoSmithKline Limited） 40Axalu/kg.After second, 3 day administration of 40Axalu/kg, fourth days after daily administration of 60AxaIu/kg, and 7 days after operation end,Two groups were observed in patients with plasma prothrombin time, activated partial thromboplastin time, plasma fibrinogen and D-two dimer medication changes before and after. Results： the use of Salvia mihiorrhiza in plasma of patients with plasma prothrombin time, activated partial thromboplastin time, fibrinogen and D-two dimer had obvious improve- ment than before treatment.With low molecular weight heparin in the prevention of the control group had no significant differ- ence （P〉0.05）. Conclusion： Salvia miltiorrhiza can improve the low joint replacement operation in patients with high blood co- agulation state, having antithrombotic effects, preliminary studies suggest that Danshen preparations for major orthopedic opera- tion postoperative prophylaxis of deep venous thrombosis.