抗凝治疗对慢性阻塞性肺疾病患者血清TNF-α及白介素表达的影响

Effect of Anticoagulant Therapy on Serum TNF-α and Interleukin Expression in Patients with Chronic Obstructive Pulmonary Disease

目的: 探讨对慢性阻塞性肺疾病患者使用抗凝药物,观察使用抗凝药物后患者血清内TNF-α和白介素变化水平。 方法: 将94例慢性阻塞性肺疾病患者随机分为常规组和抗凝组,每组47例,常规组采用噻托溴胺联合沙美特罗氟替卡松再口服羧甲司坦片,抗凝组在常规组的基础上使用华法林钠片。观察两组患者的临床疗效、D二聚体定量对比、TNF-α、IL-18和IL-6指标检测及不良反应的发生率的相关性。 结果: 抗凝组COPD患者在临床效果的显效率明显高于常规组(P<0.05),在有效率上无明显变化,常规组COPD患者在无效率方面明显高于抗凝组(P<0.05);治疗前两组无明显变化(P>0.05),治疗后的两组D二聚体均下降且治抗凝组明显低于常规组(P<0.05)。两组在治疗前无差异(P>0.05),治疗后两组的TNF-α、IL-18和IL-6的水平明显少于治疗前并抗凝组上述指标低于常规组(P<0.05);常规组和抗凝组均出现不同程度瘀斑、血小板数量增加等症,单瘀斑自行消退,血小板及凝血时间回归正常水平,两组无差异性(P>0.05)。 结论: 慢性阻塞性肺疾病患者在使用止咳化痰药物的同时加服抗凝治疗可明显抑制患者血清中TNF-α及白介素18、白介素6的水平表达,COPD的临床疗效明显改善,值得推广使用。

Objective: To study effect of TNF-α and interleukin(IL-18andIL-6)in patients with chronic obstructive pulmonary disease using anticoagulant drugs. Method: 94 patients were divided into two groups, 47 in each group. The conventional group used common therapy, and the anticoagulation group used anticoagulant drugs on the basis of the conventional group. Observe the following indicator changes. Results: The effective rate of COPD patients in the anticoagulation group was significantly higher than that in the conventional group(P<0.05). There was no difference between the two groups before treatment (P > 0.05). After treatment, the levels of TNF - α, IL-18 and IL-6 in the two groups were significantly lower than those in the anticoagulant group (P < 0.05). The patients in the routine group and anticoagulant group had different degrees of ecchymosis, increased platelet count and other symptoms. The single ecchymosis disappeared by itself, and the platelet and coagulation time returned to the normal level. There was no difference between the two groups (P > 0.05). Conclusion: The expression of TNF - α, IL-18 and IL-6 in the serum of patients with COPD can be significantly inhibited by antitussive and expectorant drugs combined with anticoagulant therapy. The clinical effect of COPD is obviously improved, which is worth popularizing.