柳氮磺胺吡啶加用低分子肝素对溃疡性结肠炎疗效及高凝状态的影响观察

Combination of sulfasalazine and low-molecular-weight heparin in the treatment of ulcerative colitis and Hypercoagulation

目的探讨柳氮磺胺吡啶(SASP)加用低分子肝素(LMWH)对溃疡性结肠炎(UC)的疗效及高凝血状态的影响。方法选取2014年1月至2016年3月本院消化内科收治的64例UC住院患者为研究对象,随机分为常规组与治疗组,每组各32例。常规组采用常规SASP进行治疗,治疗组采用SASP+LMWH进行治疗。比较两组治疗总有效率、治疗前后内镜检查(EI)评分、血清C-反应蛋白水平、D-二聚体和血小板计数变化。结果治疗组总有效率为93.75%,高于常规组的75.00%,差异有统计学意义(P<0.05)。经过一个疗程治疗后两组EI评分、炎症指标及凝血指标均有好转(P<0.05),治疗后治疗组EI评分(3.17±1.56)分、血清CRP(8.11±2.52)mg/L、D-二聚体(212.65±92.07)μg/L、血小板计数(201.71±34.85)×10~9/L,上述指标水平均显著低于常规组(P<0.05)。两组不良反应总发生率比较差异无统计学意义(P<0.05)。结论在常规使用SASP基础上,加用低分子肝素可有效提升UC治疗总有效率,对改善高凝状态有良好效果,安全性良好。

Objective To investigate the effect of Combination of sulfasalazine and low-molecular-weight heparin in the treatment of ulcerative colitis （UC）and Hypercoagulation. Methods 64 patients diagnosed with UC were randomly assigned into two groups,who were treated either with Sulfasalazine （control group）or combination of sulfasalazine and low-molecular-weight heparin （treatment group）. Endoscopic index （EI）, markers of the inflammation （CRP）, coagulation （D-dimer and platelet count）were examined before and after the treatment, and compared between the two groups. Results There was significant difference between the control group and the treatment group. The total effective rate （93.75%）of the treated group was significantly higher than that of the control group （75.00%）. After treatment,indices in both group improved. In control group, EI score,CRP level,D-dimer level,and platelet count were （3.17±1.56）, （8.11±2.52） mg/L, （212.65±92.07） μg/L and （201.71±34.85）×10^9/L,respeetively. In the treatment group,these levels were （4.52±1.85）, （10.24±1.50） mg/L, （288.53±102.64） g/L and （245.61±58.69）×10^9/L,respeetively. The levels of these in- dexes in the treatment group were significantly lower than those in the control group （P 〈 0.05）. Conclusion Combination of sul- fasalazine and low-molecular-weight heparin improves the microvascolar of colonic tissue in ulcerative colitis through its antithrombotic and anti-inflammatory effect.