Objective: Acute pulmonary thromboembolism (PTE) is a serious high mortality pulmonary vascular disease whose effective treatment decreases morbidity and mortality. To determine if low-molecular-weight-heparin (LMWH) ...Objective: Acute pulmonary thromboembolism (PTE) is a serious high mortality pulmonary vascular disease whose effective treatment decreases morbidity and mortality. To determine if low-molecular-weight-heparin (LMWH) is clinically as efficient and safe as unfractionated heparin (UH) in patients with diagnosis of acute non-massive PTE, our study compares the efficacy, adverse effects and costs of LMWH and UH. Methods: One hundred and fourteen patients with non-massive acute PTE were randomly divided into LMWH (nadroparin calcium) and UH groups. Oxygenation index, D-dimer, fibrinogen (FG), lung ventilation/perfusion (V/Q) scan and computed tomography pulmonary angiography (CTPA) were observed before anticoagula-tion and on day 14 after anticoagulation. Results: In both groups, the ABG (arterial blood gas) analysis showed PaO2 and PaCO2 were elevated, P(A-a)O2 was decreased and oxygenation index (PaO2/FIO2) was elevated, D-dimer and fibrinogen were decreased, lung V/Q and CTPA showed embolized segments reduced (P<0.05). Hemorrhage and thrombocytopenia occurred in 3.5% of the LMWH group. Hemorrhage occurred in 5.3% and thrombocytopenia occurred in 7.0% of the UH group. The average cost in the LMWH group was RMB 1218.60 Yuan and RMB 1541.40 Yuan in the UH group. Conclusion: LMWH and UH are equally effective for treatment of non-massive acute PTE, but LMWH may have a lower prevalence of complications and is less expen-sive.展开更多
Objective Heparin-induced thrombocytopenia(HIT)is a complication characterized by thrombocytopenia,hemorrhage and/or thrombosis,which is caused by initial or repeated application of unfractionated heparin(UFH)and low-...Objective Heparin-induced thrombocytopenia(HIT)is a complication characterized by thrombocytopenia,hemorrhage and/or thrombosis,which is caused by initial or repeated application of unfractionated heparin(UFH)and low-molecular-weight heparin(LMWH).This study aims to summarize the clinical features of HIT in patients undergoing cardiac surgery.展开更多
目的探讨枸橼酸抗凝(regional citrate anticoagulation,RCA)在维持性血液透析(maintenance hemodialysis,MHD)患者中的效果及对MHD患者血脂代谢的影响。方法将60例MHD患者随机分为RCA组(实验组)和普通肝素抗凝(unfraetionaled heparin,...目的探讨枸橼酸抗凝(regional citrate anticoagulation,RCA)在维持性血液透析(maintenance hemodialysis,MHD)患者中的效果及对MHD患者血脂代谢的影响。方法将60例MHD患者随机分为RCA组(实验组)和普通肝素抗凝(unfraetionaled heparin,UFH)组(对照组),每组各30例。比较两组患者每次透析治疗后透析器整体纤维容积(total cellvolume,TCV)变化情况,患者在入组前、透析3个月、12个月血脂代谢的各项指标情况。结果⑴两组透析器使用后TCV变化情况比较,差异无统计学意义(P>0.05)。⑵对血脂的影响:①透析12个月后,两组总胆固醇(total cholesterol,TC)与透析前比较,差异无统计学意义(均P>0.05),对照组三酰甘油(three glycerine,TG)、脂蛋白(a)[(level of apolipoprotein(a),Lp(a)]、低密度脂蛋白(low density level of apolipoprotein,LDL-c)、极低密度脂蛋白胆固醇(very low density lipoprotein cholesterol,VLDL-c)均较透析前升高(均P<0.05),高密度脂蛋白胆固醇(high density level of apolipoprotein cholesterol,HDL-c)较透析前降低(P<0.05);实验组LP(a)较透析前升高、TG则比透析前降低(均P<0.05);②透析12个月两组比较,实验组TG、LDL-c、VLDL-c较对照组降低,组间比较,差异具有统计学意义(均P<0.05)。结论 RCA体外抗凝效果确切,透析器使用后TCV不受影响,透析效果好,且不良反应少;应用RCA体外抗凝不加重MHD患者血脂代谢紊乱。展开更多
文摘Objective: Acute pulmonary thromboembolism (PTE) is a serious high mortality pulmonary vascular disease whose effective treatment decreases morbidity and mortality. To determine if low-molecular-weight-heparin (LMWH) is clinically as efficient and safe as unfractionated heparin (UH) in patients with diagnosis of acute non-massive PTE, our study compares the efficacy, adverse effects and costs of LMWH and UH. Methods: One hundred and fourteen patients with non-massive acute PTE were randomly divided into LMWH (nadroparin calcium) and UH groups. Oxygenation index, D-dimer, fibrinogen (FG), lung ventilation/perfusion (V/Q) scan and computed tomography pulmonary angiography (CTPA) were observed before anticoagula-tion and on day 14 after anticoagulation. Results: In both groups, the ABG (arterial blood gas) analysis showed PaO2 and PaCO2 were elevated, P(A-a)O2 was decreased and oxygenation index (PaO2/FIO2) was elevated, D-dimer and fibrinogen were decreased, lung V/Q and CTPA showed embolized segments reduced (P<0.05). Hemorrhage and thrombocytopenia occurred in 3.5% of the LMWH group. Hemorrhage occurred in 5.3% and thrombocytopenia occurred in 7.0% of the UH group. The average cost in the LMWH group was RMB 1218.60 Yuan and RMB 1541.40 Yuan in the UH group. Conclusion: LMWH and UH are equally effective for treatment of non-massive acute PTE, but LMWH may have a lower prevalence of complications and is less expen-sive.
文摘Objective Heparin-induced thrombocytopenia(HIT)is a complication characterized by thrombocytopenia,hemorrhage and/or thrombosis,which is caused by initial or repeated application of unfractionated heparin(UFH)and low-molecular-weight heparin(LMWH).This study aims to summarize the clinical features of HIT in patients undergoing cardiac surgery.
文摘目的探讨枸橼酸抗凝(regional citrate anticoagulation,RCA)在维持性血液透析(maintenance hemodialysis,MHD)患者中的效果及对MHD患者血脂代谢的影响。方法将60例MHD患者随机分为RCA组(实验组)和普通肝素抗凝(unfraetionaled heparin,UFH)组(对照组),每组各30例。比较两组患者每次透析治疗后透析器整体纤维容积(total cellvolume,TCV)变化情况,患者在入组前、透析3个月、12个月血脂代谢的各项指标情况。结果⑴两组透析器使用后TCV变化情况比较,差异无统计学意义(P>0.05)。⑵对血脂的影响:①透析12个月后,两组总胆固醇(total cholesterol,TC)与透析前比较,差异无统计学意义(均P>0.05),对照组三酰甘油(three glycerine,TG)、脂蛋白(a)[(level of apolipoprotein(a),Lp(a)]、低密度脂蛋白(low density level of apolipoprotein,LDL-c)、极低密度脂蛋白胆固醇(very low density lipoprotein cholesterol,VLDL-c)均较透析前升高(均P<0.05),高密度脂蛋白胆固醇(high density level of apolipoprotein cholesterol,HDL-c)较透析前降低(P<0.05);实验组LP(a)较透析前升高、TG则比透析前降低(均P<0.05);②透析12个月两组比较,实验组TG、LDL-c、VLDL-c较对照组降低,组间比较,差异具有统计学意义(均P<0.05)。结论 RCA体外抗凝效果确切,透析器使用后TCV不受影响,透析效果好,且不良反应少;应用RCA体外抗凝不加重MHD患者血脂代谢紊乱。
