低分子肝素治疗对AECOPD患者肺功能和凝血功能的影响

Influence of low molecular heparin on the blood coagulation function and lung function in AECOPD patients

目的:探讨低分子肝素治疗对慢性阻塞性肺疾病急性加重期(AECOPD)患者肺功能和凝血功能的影响。方法:选择100例AECOPD患者作为研究对象,根据收治顺序单双号分为观察组和对照组,每组各50例,两组诊断明确后即给予AECOPD常规基础治疗,此外,观察组采用低分子肝素治疗,治疗10d,比较两组治疗前后动脉血气指标:氧分压(PaO2)、氧饱和度(SaO2)、二氧化碳分压(PaCO2);肺功能指标:用力肺活量(FVC)、一秒用力呼气容积(FEV1)、FEV1/FVC;凝血功能指标:纤维蛋白原(Fib)、D-二聚体(D-D)、活化部分凝血活酶时间(APTT)、血浆凝血酶原时间(PT)、凝血酶时间(TT)。结果:与治疗前比较,对照组治疗后PaO2、SaO2、FEV1、FVC、FEV1/FVC均明显升高,D-D、PaCO2明显降低(P<0.05);观察组治疗后SaO2、PaO2、FEV1、FVC、FEV1/FVC、PT、TT、APTT均明显升高,且与对照组治疗后相比也明显升高(P<0.05),PaCO2、Fib、D-D均明显降低,且与对照组治疗后相比也明显降低(P<0.05)。结论:AECOPD患者采用低分子肝素治疗更有助于改善动脉血气、肺功能和凝血功能。

Objective：To explore the influence of low molecular heparin on the blood coagulation function and lung function in acute exacerbation of chronic obstructive pulmonary disease（AECOPD）patients.Methods：A total of 100 cases AECOPD patients were chosen and divided into observation group and control group according to the present order and odd number,50 cases in each group.They were all given AECOPD conventional symptomatic treatment;on this basis,patients in the observation group were treated with low molecular heparin.A total of 10 dafter treatment,two groups were compared before and after treatment in terms of the arterial blood gas index such as oxygen partial pressure（PaO2）,oxygen saturation（SaO2）,carbon dioxide partial pressure（PaCO2）,pulmonary function index such as forced expiratory volume in one second（FEV1）and forced vital capacity（FVC）,FEV1/FVC,blood coagulation function index such as fibrinogen（Fib）,D-dimer（D-D）,activated partial blood coagulation time（APTT）live enzymes,plasma prothrombin time（PT）,thrombin time（TT）.Results：Compared with before treatment,the levels of PaO2,SaO2,FEV1 and FVC,FEV1/FVC in control group after treatment were significantly elevated and PaCO2,D-D were significantly reduced（P〈0.05）;the levels of PaO2,SaO2,FEV1 and FVC,FEV1/FVC,PT,TT and APTT in observation group after treatment were significantly increased,and were significantly higher than the control group after treatment,PaCO2,D-D,Fib were significantly lower,and were lower than the control group after treatment（all P〈0.05）.Conclusions：AECOPD patients treated with low molecular heparin can help to improve the arterial blood gas,lung function and blood coagulation function.