低分子肝素钙联合氧疗用于慢性阻塞性肺疾病合并肺心病患者的效果

Effects of low molecular weight heparin calcium combined with oxygen therapy in treatment of COPD patients with pulmonary heart disease

目的:观察低分子肝素钙联合氧疗用于慢性阻塞性肺疾病(COPD)合并肺心病患者的效果。方法:选取2021年1月至2022年12月项城市中医院收治的82例COPD合并肺心病患者进行前瞻性研究,按随机数字表法将其分为对照组(n=41)和观察组(n=41)。对照组采用氧疗,观察组在对照组基础上联合低分子量肝素钙注射液治疗,比较两组治疗前后炎性因子[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平、心功能指标[左心室射血分数(LVEF)、心排出量(CO)]水平、B型尿钠肽(BNP)水平、血液流变学指标[血浆黏度(PV)、血细胞比容(HCT)、全血高切黏度(BVH)、全血低切黏度(BVL)]水平和不良反应发生率。结果:治疗后,两组IL-6、TNF-α、hs-CRP水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组CO、LVEF水平均高于治疗前,且观察组高于对照组,两组BNP水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组PV、HCT、BVH、BVL水平低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:低分子肝素钙联合氧疗用于COPD合并肺心病患者可提高心功能指标水平,降低炎性因子、BNP和血液流变学指标水平,其效果优于单纯氧疗。

Objective:To observe effects of low molecular weight heparin calcium combined with oxygen therapy in treatment of patients with chronic obstructive pulmonary disease(COPD)complicated with pulmonary heart disease.Methods:A prospective study was conducted on 82 patients with COPD complicated with pulmonary heart disease admitted to Xiangcheng City Hospital of Traditional Chinese Medicine from January 2021 to December 2022.They were divided into control group(n=41)and observation group(n=41)according to the random number table method.The control group was treated with oxygen therapy,while the observation group was treated with low molecular weight heparin calcium injection on the basis of that of the control group.The levels of inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],the cardiac function index levels[left ventricular ejection fraction(LVEF),cardiac output(CO)],the B-type natriuretic peptide(BNP)level,the hemorheology index levels[plasma viscosity(PV),hematocrit(HCT),high shear whole blood viscosity(BVH),low shear whole blood viscosity(BVL)],and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:After the treatment,the levels of IL-6,TNF-αand hs-CRP in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of CO and LVEF in the two groups were higher than those before the treatment,and those in the observation group were higher than those in the control group;the levels of BNP in the two groups were lower than those before the treatment,and that in the observation group was lower than that in the control group;and the differences were statistically significant(P<0.05).After the treatment,the levels of PV,HCT,BVH and BVL in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Low molecular weight heparin calcium combined with oxygen therapy in the treatment of the COPD patients with pulmonary heart disease can improve the levels of cardiac function indexes and reduce the levels of inflammatory factors,the BNP and the hemorheology indexes.Moreover,it is superior to single oxygen therapy.