依诺肝素对慢性阻塞性肺病伴急性加重患者免疫功能的影响

目的 探讨依诺肝素对慢性阻塞性肺病伴急性加重（AECOPD）患者免疫功能的影响,为合理应用依诺肝素提供参考.方法 慢性阻塞性肺病伴急性加重患者80例,随机分为观察组与对照组各40例,两组均采用常规持续低流量吸氧、抗感染、解痉平喘、化痰治疗.观察组在此基础上加用依诺肝素治疗,比较两组相关临床指标及免疫功能的变化.结果 对照组患者治疗后CRP、CO2分压、碳酸氢根比治疗前下降（P〈0.05）.观察组患者治疗后CRP、D-二聚体、CO2分压、CD3＋、CD4＋、CD4＋/CD8＋、IgA、IgG、IgM与治疗前比较,差异有统计学意义（P〈0.05）.观察组治疗后CRP、D-二聚体、CO2分压、CD3＋、CD4＋、CD4＋/CD8＋、IgA、IgG、IgM值与对照组比较,差异有统计学意义（P〈0.05）.结论 慢性阻塞性肺病伴急性加重治疗中应用依诺肝素能够有效提高近期疗效,增强细胞免疫和体液免疫,从而改善免疫功能,值得推广应用.

Objective To discuss the influence of enoxaparin on inmmne function of patients with acute exacerbation of chronic obstructive pulmonary disease, and to provide reference for the reasonable application of enoxaparin. Methods A total of 80 patients with AECOPD were randomly divided into two groups： 40 cases in the observation group and 40 cases in the control group.All patients received the conventional treatments including persistent low flow oxygen, anti-infection, antispasmodic, antiasthma and Phlegm treatment. Enoxaparin were added in the observation group, the changes of serum CD3＋, CD4＋, CD4＋/CD8＋, NK, IgA, IgG, IgM, IgE and CRPand D-dimer, INR and PaCO2, HCO3 were tested. Result The control group after treatment in patients with CRP, CO2 partial pressure, before more bicarbonate treatment decreased （ P〈0.05 ） . Observation group after treatment in patients with CRP, D - dimer, CO2 partial pressure, CD3＋, CD4＋, CD4＋ / CD8＋, IgA, IgG, IgM before the treatment difference was statistically significant （P〈0.05） .Observation group compared with control group, after treatment of CRP, D-dimer, CO2 partial pressure, CD3＋, CD4＋, CD4＋/CD8＋, IgA, IgG, IgM value difference was statistically significant （P〈0.05） . Conclusion The use of enoxaparin in the treatment of acute exacerbation of chronic obstructive pulmonary disease can effectively improve the short-term efficacy, enhance the cellular immunity and humoral immunity, thereby improving immune function, is worthy of popularization and application.