低分子肝素对老年慢性阻塞性肺疾病急性加重期患者血浆内皮素的影响

The Effect of Low Molecular Weight Heparin on Plasma Endothelin in Elderly Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的探讨低分子肝素(LMW)对老年慢性阻塞性肺疾病(COPD)急性加重期患者血浆内皮素(ET)的影响。方法老年COPD急性加重期患者62例,随机分为研究组(30例)和观察组(32例),观察组给予常规治疗(卧床休息、持续低流量吸氧、抗感染、解痉平喘、袪痰止咳等),研究组在常规治疗的基础上加用LMW0.4IU,皮下注射,每日1次,疗程为10d,观察治疗前、后血浆ET的变化,并与健康查体者做对照。观察患者治疗前、后临床症状变化。结果研究组和观察组血浆ET水平均比健康对照组显著升高(P<0.01);研究组治疗后血浆ET水平均显著下降(P<0.01),观察组治疗后血浆ET水平均明显下降(P<0.05),治疗后两组患者血浆ET水平有显著性差异(P<0.05)。研究组临床疗效明显好于观察组,两组总有效率差异有统计学意义(P<0.05)。结论 LMW治疗老年COPD急性加重期能够显著降低血浆ET水平,并有效改善临床疗效。

Objective To study the effect of low molecular weight（ LMW） heparin on plasma endothelin in elderly patients with acute exacerbation of chronic obstructive pulmonary disease（ COPD）. Methods Sixty-two cases of elderly patients with acute exacerbation of chronic obstructive pulmonary disease were divided randomly into study group（ 30 cases） and observation group（ 32 cases）. The observation group was given routine therapy（ bed rest,continued low flow oxygen,anti-infection,spasmolysis,cough expectorant,etc.）. The study group was additionally given LMW 0. 4IU,subcutaneous injection,once a day,treatment for 10 days,observed the change of the plasma ET before and after treatment,and controlled with the health check ones on the basis of conventional therapy. To observe the changes of clinical symptoms before and after treatment. Results The plasma ET levels in study group and the observation group increased significantly compared to healthy control group（P〈0. 01）. The plasma ET levels in the study group were significantly decreased after treatment（P〈0. 01）,and in the observation group were obviously decreased（P〈0. 05）. The clinical curative effect of the study group was significantly better than that in the observation group,the differences were statistically significant（P〈0. 05）. Conclustion LMW heparin can profoundly reduce the plasma endothelin levels in elderly patients with acute exacerbation of chronic obstructive pulmonary disease and can effectively improve the clinical efficacy.