低分子量肝素钙对慢性阻塞性肺疾病急性加重期患者肺功能和凝血功能的影响

Effect of Low Molecular Weight Heparin on Lung Function and Coagulation Function in Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease

目的探讨低分子量肝素钙治疗对慢性阻塞性肺疾病急性加重期(acute exacerbations of chronic obstructive pulmonary disease,AECOPD)患者肺功能和凝血功能的影响。方法根据入选标准,随机选取2010-08/2013-08月在作者医院确诊并接受治疗的慢性阻塞性肺疾病急性加重期患者84例作为研究对象,按照随机数字表法随机分为抗凝组和对照组,各42例。对照组患者采取常规治疗;抗凝组给予低分子肝素5000 U,腹部皮下注射1/d,10天为一个疗程。结果治疗后抗凝组患者的动脉血气指标改善程度均显著优于对照组(P<0.05);治疗后抗凝组患者的血粘度指标(高切粘度和低切粘度)改善程度均显著优于对照组患者(P<0.05);抗凝组患者治疗后的肺功能指标(FEV1和FEV1/FVC)改善程度均显著高于对照组(P<0.05);抗凝组患者治疗后的呼吸困难Borg评分改善程度显著优于对照组患者(t=7.612,P<0.05)。抗凝组与对照组患者住院时间的比较明显缩短(P<0.05);治疗后抗凝组患者的凝血功能指标改善程度均显著优于对照组患者(P<0.05)。结论低分子量肝素能有效改善AECOPD患者血黏度、肺功能、凝血功能、动脉血气指标、呼吸困难指数改善明显,减少住院时间显著,使用安全方便,值得临床推广。

Objective To investigate the effect of low molecular weight heparin on lung function and coagulation function in patients with acute exacerbations of chronic obstructive pulmonary disease （AECOPD） . Methods Based on inclusion criteria, 84 patients from August 2010 to August 2013 were diagnosed and treated for acute exacerbations of chronic obstructive pulmonary disease, in accordance with the random number table , were divided into anticoagulant group and control group, with 42 cases in each group. Control group accepted conventional treatment; anticoagulant group were given low molecular weight heparin 5000 U, abdominal subcutaneous injection 1/d, 10 days for a course of treatment.Results Arterial blood gas indexes in anticoagulant group patients were significantly better than those the control group （P〈0.05）. After treatment blood viscosity index （high shear viscosity and low shear viscosity） in anticoagulant group was significantly better than that in the control group （P〈0.05） . Lung function index （FEV1 and FEV1/ FVC） in anticoagulant group was significantly better than the control group （t = 2.856,P〈0.05） . Borg dyspnea score in anticoagulant group was significantly better than the control group （t = 7.612, P〈0.（15） . The anticoagulant group had shorter hospital stay than the control group （P〈0.05） .Coagulation parameters in anticoagulant group was significantly better than the control group （P〈0.05） . Conclusion Low molecular weight heparin anticoagulant therapy for AECOPD patients can effectively improve blood viscosity, pulmonary function, blood coagulation, arterial blood gas index, dyspnea index, and reduce the hospitalization time, which is safe and convenient, worthy of promotion.