低分子肝素钙治疗重度、极重度慢性阻塞性肺疾病急性加重期患者的临床疗效

Clinical efficacy of low molecular weight heparin calcium for patients with severe and extremely severe acute exacerbation of chronic obstructive pulmonary disease

目的探讨低分子肝素钙治疗重度、极重度慢性阻塞性肺疾病急性加重期(AECOPD)患者的临床效果。方法将128例重度、极重度AECOPD患者随机分为对照组与治疗组,每组64例;对照组给予氧疗、抗感染、支气管扩张剂、激素、无创通气等常规治疗,治疗组则在对照组治疗基础上加用低分子肝素钙,比较两组患者治疗前后的凝血功能、血气分析以及治疗有效率。结果治疗后1周,治疗组治疗总有效率高于对照组(P<0.05);两组患者的纤维蛋白原降解产物(FDP)、D-二聚体(DD)水平均较治疗前降低,且治疗组低于对照组;两组Pa O2均较治疗前升高,且治疗组高于对照组;两组Pa CO2较治疗前降低,且治疗组低于对照组(均P<0.05)。结论低分子肝素钙能有效缓解重度、极重度AECOPD患者的高凝、低氧、高碳酸血症状态,提高治疗有效率,改善患者预后,值得临床推广使用。

Objective To investigate the clinical efficacy of low molecular weight heparin calcium for severe and extremely severe acute exacerbation of chronic obstructive pulmonary disease（ AECOPD）. Methods A total of 128 patients with severe and extremely severe AECOPD were randomly divided into control group and treatment group,with 64 cases in each group; the control group was given conventional treatment such as oxygen therapy,anti-infection,bronchodilators,hormones,and non-invasive ventilation,while the treatment group was given low molecular weight heparin calcium additionally based on the therapies in the control group. The coagulation function and indices of blood gas analysis before and after treatment,as well as the effective rate of treatment were compared between the two groups.Results After one week of treatment,the total effective rate of the treatment group was higher than that of the control group（ P〈0. 05）;the levels of fibrinogen degradation products（ PDF） and D-dimer（ DD） decreased in both groups than those before treatment,and the levels in the treatment group were lower than those in the control group; the level of PaO2 increased in both groups than that before treatment,and the level in the treatment group was higher than that in the control group; the level of PaCO2 decreased in both groups than that before treatment,and the level in the treatment group was lower than that in the control group（ all P〈0. 05）. Conclusion Low molecular weight heparin calcium can effectively alleviate the symptoms of high coagulation,hypoxia and hypercapnia of patients with severe and extremely severe AECOPD,increase the effective rate of treatment,and improve patient prognosis,which is worthy of clinical application.