低分子肝素应用于人工肝治疗重型肝炎的临床研究

Clinical Study on Low Molecular Weight Heparin in Treatment of Severe Hepatitis with Artificial Liver

探讨低分子肝素(LMWH)在人工肝治疗重型肝炎患者时的安全性及有效性。方法20例重型肝炎患者随机分为常规肝素组与LMWH组,给予人工肝治疗后,检测不同时间点血红蛋白(Hb)、国际正常化比率(INR)、活化的部分凝血活酶时间(APTT)、纤维蛋白原(Fbg)、凝血酶时间(TT)、Ⅷ因子(F8)的变化,并观察治疗中不良事件的发生情况。结果肝素组和LMWH组对Hb均无明显的影响(P>0.05);治疗2h,肝素组APTT及TT升高,治疗后下降;LMWH组INR、APTT下降;2组均可引起Fbg升高、F8下降;肝素组有血压下降及出血倾向并发症,而LMWH组无并发症发生。结论LMWH应用于人工肝治疗重型肝炎患者是安全和有效的。

Objective To study the safety and effectiveness of low molecular weight heparin(LMWH) in treatment of severe hepatitis with artificial liver. Methods Twenty patients with severe hepatitis were divided into heparin group and LMWH group randomly. All of the patients were treated with artificial liver. The changes of hemoglobin (Hb),international normal rate(INR),activated partial thromboplastin time(APTT),fibrinogen(Fbg),thrombin time(TT) and factorⅧ were evaluated before and after the treatment with artifical liver in two groups respectively. The adverse effects during treatment were also observed. Results There was no significant difference in Hb level before and after treatment between two groups. In heparin group,APTT and TT levels increased significantly in 2 hours after treatment with artificial liver, then decreased. The INR and APTT decreased signficantly in LMWH group; The Fbg and F8 decreased significantly in two groups. In heparin group there were complications of blood pressure lowering and bleeding, but in LMWH group no complications were found. Conclusions The application of LMWH in artificial liver is effective and safe in the treatment of severe hepatitis.