黄体酮联合低分子肝素钠治疗COPD高凝状态并Ⅱ型呼吸衰竭的临床研究

Clinical Study on Progesterone Combined with Low Molecular Heparin Sodium Hypercoagulable State in Treatment of COPD with Type Ⅱ Respiratory Failure

目的:探讨黄体酮联合低分子肝素钠治疗COPD高凝状态并Ⅱ型呼吸衰竭的临床疗效。方法:选择60例COPD高凝状态并Ⅱ型呼吸衰竭患者,随机分为两组,治疗组30例,对照组30例。对照组给予抗感染、解除支气管痉挛平喘化痰、强心利尿,氧疗,呼吸兴奋剂,维持水电酸碱平衡等改善肺心功能对症治疗,治疗组在对照组基础上给予黄体酮注射液20mg肌肉注射,1次/d,低分子肝素钠5000Uih,1次/d,疗程14d;所有患者在治疗始末均做血气分析、血常规、血流变检验。结果:治疗组患者口唇指端、趾端发绀较对照组明显减轻。动脉血氧分压升高、二氧化碳分压降低;血红蛋白、红细胞数、红细胞压积、血浆及全血黏度(高切和低切)均明显下降(P<0.01),均较对照组减少。结论:黄体酮联合低分子肝素钠可刺激通气,增强呼吸功能,纠正高碳酸血症和低氧血症,明显改善血液黏滞度、血流变学指标和继发性红细胞、血红蛋白增多症。

Objective：To investigate the effects of progesterone combined with low molecular heparin sodium in treatment of COPD hypercoagulable state and type Ⅱ respiratory failure clinical curative effect.. Method：60 cases of COPD hypercoagulable state and type II respiratory failure patients were randomly divided into two groups：30 cases in the treatment group,30 cases in the control group. The control group was given anti infection,lifting bronchial spasm resolving sputum and relieving asthma,strong heart diuresis,oxygen therapy,respiratory stimulant,maintaining water acid-base balance improvement of pulmonary function in symptomatic treatment of heart,The treatment group was given 20mg intramuscular injection of progesterone,once daily,low molecular weight heparin sodium 5000 U ih,1 times / day,lasted for 14 d;all patients were treated by both analysis of blood gas,blood,blood rheology test. All patients were treated by both blood gas analysis,blood routine,rheological test. Result：The treatment group：Patients with lip finger,toe,significantly relieve cyanosis. Arterial blood oxygen partial pressure increased,the partial pressure of carbon dioxide decreased; hemoglobin,red blood cell count,hematocrit,plasma and whole blood viscosity（high shear and low cut ）were significantly decreased（ P〈0.01 ）were less than those in control group. Conclusion：The results suggest that progesterone combined with low molecular heparin sodium stimulates ventilation, enhanced respiratory function,correct hypercapnia and hypoxemia,improve blood viscosity,blood rheology and secondary erythrocyte,hemoglobin.