慢性心衰患者失代偿期抗凝治疗的临床观察

Anticoagulation Therapy Clinical Observation in Decompensated Period of Chronic Heart Failure Patients

目的研究慢性心衰患者失代偿期抗凝治疗的必要性和可行性。方法选择我院2011年8月-2012年10月慢性心衰急性失代偿期住院病例共100例,随机分为抗凝组42例,对照组58例。抗凝组患者在常规抗心衰治疗的基础上加用低分子肝素5000u每日一次皮下注射;对照组患者只给予常规抗心衰治疗。治疗后对两组患者的NT-proBNP、心脏彩超(LVEF、LVEDD)、生活质量评估及临床终点事件进行比较分析。结果抗凝治疗一周后,实验组心功能改善明显,临床转归明显优于常规治疗组,两组比较具有统计学意义(P<0.05)。严重的临床终点事件与常规治疗组比较无增加,两组比较不具有统计学意义(P>0.05)。结论抗凝治疗可显著改善慢性心衰失代偿患者抗心衰治疗的效果,减少住院时间,并不增加严重的出血事件。临床应用结果优于常规抗心衰治疗。

Objective To study necessity and feasibility of anticoagulation therapy in the decompensated period of chronic heart failure patients.Method 100 hospitalized cases of decompensated period of chronic heart failure patients from 2011 August to 2012 October were selected,and randomly divided into anticoagulant group of 42 cases and 58 cases in control group.Patients in the anticoagulant therapy group were treated with low molecular weight heparin 5000u once daily subcutaneous injection based on routine anti heart failure treatment,and patients in the control group only received routine anti heart failure therapy.Then conduct comparison analysis on the NT-proBNP,echocardiography （LVEF LVEDD）,the life quality assessment and clinical endpoint events after treatment.Result After one week of anticoagulation therapy,the cardiac function of patients in the experimental group was improved significantly,and the clinical outcome was superior to conventional treatment group,the two groups was statistically significant（P＜0.05）.There was no increase in comparison of clinical endpoints events with conventional therapy group,the two groups was not statistically significant （P＞0.05）.Conclusion Anticoagulation therapy could significantly improve the treatment effect of chronic heart failure patients in decompensated period,decrease hospitalization time without increasing serious bleeding events,and its clinical application results were superior to conventional heart failure treatment.