低分子肝素抗凝治疗对脓毒症患者的影响

Effect of Low Molecular Weight Heparin Anticoagulant Therapy on Sepsis Patients

目的:探究低分子肝素抗凝治疗对脓毒症患者的影响。方法:回顾性分析2022年12月—2023年8月遵义市第一人民医院及湖南省人民医院收治的78例脓毒症患者的临床资料。按治疗方式不同分为两组,各39例。对照组给予常规治疗,观察组在对照组基础上给予低分子肝素治疗。比较两组的健康状况、血清炎症因子、凝血功能、血管内皮功能、血栓弹力图指标和不良反应发生情况。结果:治疗后,两组急性生理和慢性健康状况(APACHEⅡ)评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组降钙素原(PCT)、白细胞介素-6(IL-6)、C反应蛋白(CRP)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、D-二聚体、血栓调节蛋白(TM)和凝血酶-抗凝血酶复合物(TAT)、组织性纤溶酶原激活剂-抑制剂-复合物(t-PAI-C)显著低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组最大振幅(MA)、血液凝固时间(K)、凝血反应时间(R)、凝固角(α)均明显高于治疗前,且观察组高于对照组,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:低分子肝素抗凝治疗脓毒症患者可以有效降低血清炎症因子水平,改善血管内皮功能、凝血功能和血栓弹力图指标,改善患者的健康状况,且安全性较高。

Objective:To explore the effects of Low Molecular Weight Heparin anticoagulant therapy on sepsis patients.Method:The clinical data of 78 patients with sepsis admitted to the Zunyi First People's Hospital and Hunan Provincial People's Hospital from December 2022 to August 2023 were retrospectively analyzed.They were divided into two groups according to different treatment methods,with 39 cases in each group.The control group was given conventional treatment,and the observation group was given Low Molecular Weight Heparin on the basis of the control group.The health status,serum inflammatory factors,coagulation function,vascular endothelial function,thromboelastogram index and adverse reactions were compared between the two groups.Result:After treatment,acute physiological and chronic health evaluation status(APACHEⅡ)scores in both groups was lower than that before treatment,and observation group was lower than that in control group,the differences were statistically significant(P<0.05).After treatment,the procalcitonin(PCT),interleukin-6(IL-6),C-reactive protein(CRP),activated partial thromboplastin time(APTT),prothrombin time(PT),D-dimer,thrombomodulin(TM)and thrombine-antithrombin complex(TAT),tissue plasminogen activator-inhibitor-complex(t-PAI-C)in two groups were significantly lower than those before treatment,and the indexes in the observation group were lower than those in control group,the differences were statistically significant(P<0.05).After treatment,maximum amplitude(MA),blood coagulation time(K),coagulation reaction time(R),coagulation angle(α)in two groups were significantly higher than those before treatment,and the indexes in the observation group were higher than those in control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Anticoagulant treatment of Low Molecular Weight Heparin in sepsis patients can effectively reduce the level of serum inflammatory factors,improve vascular endothelial function,coagulation function and thromboelastogram index,and improve the health status of patients with high safety.