氯吡格雷联合低分子肝素钙对急性加重期慢性肺源性心脏病的临床效果

The Clinical Effect of Clopidogrel Combined with Low Molecular Weight Heparin for Acute Exacerbation of Chronic Pulmonary Heart Disease

目的:探讨应用氯吡格雷(Clopidogrel)联合低分子肝素钙(LMWH)对慢性肺源性心脏病(肺心病,chronic pulmonary heart disease)急性加重期的临床疗效。方法:将诊断为慢性肺心病加重期的患者80例,随机分成治疗组40例和对照组40例。对照组采用控制感染、止咳、化痰、平喘、解痉、持续低流量吸氧、保持呼吸道通畅、强心、利尿、抗心律失常等常规治疗;治疗组在常规治疗基础上加用皮下注射低分子肝素钙和口服氯吡格雷片治疗。同步检测两组患者治疗前后血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fb)因子和肺功能(FEV1),并加以分析比较。结果:(1)治疗后治疗组Fb值明显低于对照组(P<0.01),PT、APTT、TT和FEV1明显高于对照组,差异均有统计学意义(P<0.05)。(2)治疗组和对照组临床有效率分别为80.0%、65.0%,两组比较差异有统计学意义(字2=4.815,P<0.05)。结论:氯吡格雷联合低分子肝素钙治疗慢性肺源性心脏病具有降低痰液黏稠度、抗炎及抗过敏作用,并且还可以降低血小板凝集,使肺部血流量增加,起到改善肺心病的作用,对治疗慢性肺源性心脏病特别是加重期,临床效果十分显著,值得推广应用。

Objective：To evaluate the Clopidogrel combined with Low Molecular Weight Heparin（LMWH） on acute exacerbation of chronic pulmonary heart disease.Method：80 cases with acute exacerbation of chronic pulmonary heart disease were randomly divided into the treatment group and the control group,40 cases in each group.The control group was taken conventional treatment of infection control,relieving cough,reducing sputum,relieving spasm and asthma,persistent low flow oxygen,maintain airway patency,strong heart,diuresis,anti arrhythmia,the treatment group was treated with subcutaneous injection of Low Molecular Weight Heparin and oral Clopidogrel therapy based on routine treatment. plasma prothrombin time（PT）,activated partial thromboplastin time（APTT）,thrombin time（TT）,fibrinogen（Fb） and pulmonary function（FEV1） were simultaneous detected in two groups before and after treatment.Result：Fb in the treatment group was obviously lower than that of the control group after treatment（P0.01）,PT,APTT,TT and FEV1 were higher than those in the control group,there were significant difference（P0.05）.The clinical effect in the treatment group was 80.0%,the control group was 65.0%,there was statistically significant in two groups（P0.05）.Conclusion：Clopidogrel combined with Low Molecular Heparin Calcium can reduce sputum viscosity and anti-inflammatory and anti allergic effect,and can reduce platelet aggregation,decrease the blood viscosity,for the treatment of chronic pulmonary heart disease,especially exacerbation,the clinical effect is significant,worthy of promotion and application.