普通肝素治疗肺间质纤维化疗效及对凝血功能影响

Effect of heparin on therapy of pulmonary interstitial fibrosis and coagulation function

目的:探讨普通肝素治疗肺间质纤维化疗效及对凝血功能的影响。方法:将42例间质肺疾病患者随机分为肝素组和对照组。常规治疗同时,肝素组雾化吸入肝素25mg,每日3次;对照组吸入生理盐水。疗程14d。治疗前及结束后检测血气分析、肺功能及临床指数评价。结果:与对照组比较,肝素组1s用力呼气容积占预计值百分比(FEV1占预计值%)由治疗前(42±3)%上升到(52±5)%;肺活量占预计值百分比(VC%)由治疗前(45±4)%上升到(58±2)%;血氧分压由治疗前(61±4)%上升到(78±3)%;治疗后纤维蛋白原减低明显(3.45±0.14vs.6.85±0.20,P<0.05),D-二聚体转阴率(15/21)和(7/21);临床指数由治疗前5.2±1.1下降到2.6±0.2,P<0.05。结论:普通肝素雾化吸入可抑制炎症反应、减少纤维化和抗凝,可用于治疗间质肺疾病。

Objective To investigate the effect of heparin on therapy of pulmonary interstitial fibrosis and coagulation function. Methods Forty-two patients with interstitial lung disease were enrolled and randomized into the heparin group and the control group. All patients received the same routine treatment, the patients in the hepafin group inhaled heparin 25 rag, 3 times per day; the patients in the control group inhaled saline as placebo for 14 days. Pulmonary function, arterial blood analysis and clinical index were detected before and after heparin treatment. Results Compared with the control group, in the heparin group, FEVI% in the predicted value rised from （42 ± 3）% to （52 ± 5） % after heparin treatment; VC% rised from （45 ±4）% to（58 ± 2）%; PaO2 rised from （ 61 ±4）% to （78 ± 3）%. However, after heparin treatmenti- fibrinogen in the heparin group decreased significantly （3.45 ±0.14 vs. 6.85 ±0.20, P 〈 0.05）, the D dimmer was turned to negative rate （ 15/21 ） and （7/ 21 ）, clinical index declined from 5.2 ± 1.1 to 2.6 ± 0.2 after heparin treatment （P 〈 0.05）. Conclusion Heparin aerosol inhalation could inhibit the inflammatory reaction, reduce fibrosis and anticoagulation, which can be used in the treatment of interstitial lung disease.