LMWH对不同临床特征的缺血性肠炎患者凝血功能的影响

Effect of LMWH on the blood coagulation function in ischemic colitis patients with different clinical characteristics

目的探讨缺血性肠炎(IC)患者的凝血功能改变以及低分子肝素钠(LMWH)在不同临床特征的IC患者中的疗效。方法收集、分析2012年7月至2014年7月在我院接受治疗的IC患者的临床资料,并选取30例年龄相近的体检者作为对照组。比较两组受试者的基线资料和凝血功能,并探讨LMWH在观察组患者中的疗效、不良反应以及不同临床特征所对应的凝血功能改变。结果观察组PT、APTT水平显著低于对照组,而D-二聚体、纤维蛋白原水平显著高于对照组(P<0.01);坏疽型患者的PT、APTT低于非坏疽型患者,而D-二聚体、纤维蛋白原水平更高(P<0.05);与病变≤2处的患者比较,病变>2处的患者PT、APTT水平更低,而D-二聚体、纤维蛋白原更高(P均<0.05);与治疗前比较,不同临床特征的患者治疗后的PT、APTT水平均明显升高,D-二聚体、纤维蛋白原水平明显降低(P<0.05);观察组不同病变分型、数量所对应的疗效和不良反应比较差异均无统计学意义(P>0.05)。结论 LMWH在不同病变分型、病变数量的IC患者中均有确切的疗效,均能够显著改善患者的高凝状态。

Objective To analyze the change of blood coagulation function in ischemic colitis（ IC） patients and the efficacy of LMWH for IC patients with different clinical characteristics. Methods Clinical data of IC patients received treatment in our hospital from July 2012 to July 2014 was collected and analyzed,and 30 normal people were selected as control group. The general information and blood coagulation function were analyzed between the two groups. The efficacy,adverse reaction and effect of LMWH on the blood coagulation function in IC patients with different clinical characteristics were observed. Results The levels of PT and APTT of observation group were lower than those of control group,and D-dimer and fibrinogen were higher than those of control group（ P〈0. 01）. Patients with necrosis had the lower levels of PT and APTT with higher levels of D-dimer and fibrinogen than patients without necrosis in observation group（ P〈0. 05）. Compared with patients with less than 2 lesions,patients with more than 2 lesions have lower levels of PT,APTT and higher levels of D-dimer and fibrinogen. Conclusion LMWH has a definite efficacy in IC patients with different pathological types and lesions,and it could significantly improve the hypercoagulable states.