灯盏花素注射液对下肢深静脉血栓患者凝血、血浆血磷脂酸、同型半胱氨酸及P-选择素的影响

The impact of plasma LPA,Hcy and P-selectin of breviscapini in deep venous thrombosis therapy

目的观察灯盏花素注射液对下肢深静脉血栓（DVT）患者临床疗效及血浆血磷脂酸（LPA）、同型半胱氨酸（Hcy）、P-选择素水平的影响。方法 2015年6月—2016年6月四川省绵阳市中心医院血管外科收治DVT患者120例,根据随机数字表法将患者分为观察组（n=60）及对照组（n=60）,2组绝对卧床休息、患肢抬高、制动。对照组患者皮下注射肝素钠100 U/kg,每天2次,治疗7 d后改为口服华法林,根据国际标准化比值（INR）调整华法林。观察组静脉滴注灯盏花注射液40 ml＋5%葡萄糖250 ml,持续治疗14 d后改为口服华法林,根据INR调整华法林。分别于治疗前及治疗后观察2组血栓再通率、凝血指标及血浆LPA、Hcy及P-选择素水平的变化,并观察并发症情况。结果观察组治疗7 d、14 d后股静脉、腘静脉、胫后静脉血栓再通率显著高于对照组（χ~2=7.500、5.566、4.444,8.086、6.171、8.107,P〈0.05）;观察组血浆活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）、凝血酶时间（TT）较对照组明显改善（,=242.52、232.69、202.69,P〈0.05）;血浆LPA、Hcy及P-选择素较对照组显著下降（F=245.36、315.22、342.66,P〈0.05）;并发症发生率低于对照组（χ~2=5.926,P=0.015）。结论灯盏花素注射液可提高DVT患者血栓再通率,改善患者凝血指标,降低患者血浆LPA、Hcy及P-选择素水平,安全有效,值得临床推广应用。

Objective To investigate the effect the impact of plasma phosphorus fatty acid（LPA）,homocysteine（Hcy）,P-selectin in breviscapini treatment of deep venous thrombosis.Methods One hundred and twenty cases of patients with DVT were divided into observation groups（n=60） and control group（n=60） from June 2015 to June 2016.Two groups were arranged with absolute bed rest,limb elevation.The control group were treated with subcutaneous heparin 100 U/kg,2 times a day,7 days of treatment to oral warfarin,according to international normalized ratio（INR） adjusted warfarin.Observation group were treated with intravenous Dengzhanhua 40 ml ＋5%glucose 250 ml,sustained 14 days of treatment to oral warfarin,adjusted according to INR warfarin.The clinical results and complications of two groups were compared.The recanalization rate,hemorheology and the levels of plasma LPA,Hcy,P-selectin were observed before and after treatment.Results The observation group at 7 d and 14 d after femoral vein,popliteal vein,posterior tibial vein thrombosis recanalization rate was significantly higher than the control group（χ~2=7.500,χ~2=5.566,χ~2=4.444,χ~2=8.086,χ~2=6.171,χ~2=8.107,P0.05）;the observation group of plasma activated partial thromboplastin time（APTT）,prothrombin time（PT）,thrombin time（TT） were better than the control group（F=242.52,F=232.69,F=202.69,P0.05）;plasma LPA,Hcy and P-selectin significantly decreased compared to the control group（F=245.36,F=315.22,F=342.66,P0.05）.The complication rate was lower than the control group（χ~2=5.926,P=0.015）.Conclusion Breviscapine injection can improve the recanalization rate of thrombosis in patients with DVT,improve the coagulation indexes of patients,reduce the plasma LPA,Hcy and P-selectin is safe and effective,worthy of clinical application.