生脉注射液联合低分子肝素钠改善围生期心肌病患者心功能及血栓形成临床研究

Clinical Research on Low Molecular Weight Heparin Sodium with Shengmai Injection Combined for Improving Heart Function and Thrombogenesis in Patients with Peripartum Cardiomyopathy

目的观察低分子肝素钠和生脉注射液对围生期心肌病(PPCM)患者的抗凝治疗效果。方法将80例围生期心肌病患者随机分为观察组和对照组,各40例。对照组采用常规抗心力衰竭治疗和阿司匹林进行抗凝治疗,观察组患者在对照组治疗方法的基础上加用低分子肝素钠和生脉注射液治疗,随访3至6个月。结果治疗后,两组患者的各项心功能指标均较治疗前显著改善(P<0.05),且观察组改善幅度显著高于对照组(P<0.05);两组患者的血浆D-二聚体(D-D)水平较治疗前显著下降(P<0.05),且观察组下降程度显著大于对照组(P<0.05);观察组患者中肺栓塞和深静脉血栓(DVT)的发生率显著低于对照组(P<0.05);两组患者出血发生率差异无显著性,在减少抗凝药物用量后出血症状均消失。结论应用低分子肝素钠联合生脉注射液可显著改善围生期心肌病患者的心功能,有效纠正血浆高凝状态和预防血栓形成,且不会增强出血倾向,具有较高的安全性。

Objective To observe the anticoagulation effects of low molecular weight heparin sodium combined with Shengmai Injection in treating patients with peripartum cardiomyopathy（PPCM）. Methods 80 patients with PPCM were randomly divided into the observa-tion group and the control group,40 cases in each group. The control group was treated with the conventional anti-heart failure therapy and the anticoagulation treatment of aspirin,while on this basis the observation group was added with low molecular weight heparin sodium and Shengmai Injection. The two groups were followed up after treatment for 3-6 months. Results The various cardiac function indexes after treatment in the two groups were significantly improved compared with those before treatment（ P 〈 0. 05）,and the im-provement degree of observation group was significantly higher than that of the control group（ P 〈 0. 05）;the plasma D-D levels in the two groups were significantly decreased compared with those before treatment（ P 〈 0. 05）,and the decrease degree of the observa-tion was significantly greater than that of the control group（ P 〈 0. 05）;the incidence rates of pulmonary embolism and deep venous thrombosis（DVT） in the observation group were significantly lower than those in the control group（ P 〈 0. 05）;the incidence rate of hemorrhage had no statistical difference between the two groups. The hemorrhage symptoms were disappeared after reducing anticoagulant agents. Conclusion The application of low molecular weight heparin sodium combined with Shengmai Injection in the anticoagulation treatment for PPCM patients can significantly improve the cardiac function,effectively rectify the plasma hypercoagulable state and pre-vent the thrombus formation without increasing the hemorrhage tendency and with higher security.