低分子肝素治疗川崎病患儿高凝状态的疗效  

Curative Effect of Low Melocular Heparin on Hypercoagulability of Kawasaki Disease

作　　者：李小青[1] 周南[1] 宋旸[1] 苏德成[2] 

机构地区：[1]西安市儿童医院心脏中心,西安710002 [2]西安市儿童医院中心实验室,西安710002

出　　处：《实用儿科临床杂志》2007年第1期55-56,共2页Journal of Applied Clinical Pediatrics

摘　　要：目的 观察低分子肝素（LMWH）治疗川崎病（KD）急性期血液高凝状态的临床疗效。方法 确诊为KD的46例住院患儿，对血小板（PLT）〉600×10^9／L、纤维蛋白原（FIB）〉4g／L及彩色多普勒显示有冠状动脉血栓形成的22例患儿。予LMWH注射液50～100IU／（kg·次），皮下注射，1次／d，连用7～10d。患儿按是否接受LMWH治疗分为应用LMWH组（H组）和未用LMWH组（NH组）。观察两组治疗前后血浆凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶原国际标准化比值（INR）、FIB水平、血浆黏度、血沉（ESR）、红细胞比容（HCT）等变化，并全程密切观察有无出血情况。结果 1．治疗前H组PLT与FIB显著高于NH组（Pα〈0．05）；2．治疗后两组比较，H组ESR、血浆黏度、FIB均较NH组显著降低（Pα〈0．05）；3．两组治疗前后比较，H组治疗后PLT、ESR、血浆黏度及FIB均较治疗前显著降低（Pα〈0、05）；NH组治疗后ESR较治疗前明显降低（Pα〈0.05），PLT、血浆黏度及FIB变化无统计学意义；4．两组治疗前后PT、APTT、INR变化均无统计学意义；5．H组皮下注射局部出现皮下瘀斑1例，经局部热敷4d后基本吸收消失，余无严重出血及过敏等不良反应。结论 LMWH能有效控制亚急性期KD患儿血液高凝状态，并因其生物利用度高、依从性好、不良反应少，是一种安全、有效、使用方便的改善KD高凝状态、预防微血栓形成的药物。Objective To observe the curative effect of low melocular weight heparin（ LMWH ） on the hypercoagulability in acute Kawasaki disease（KD）. Methods Forty - six patients were diagnosed KD. Twenty - two cases out of all KD patients whose serum concentration of whether platelet （PLT） or fibrinogen （FIB） was significantly increased or who were found thrombus in their coronary artery by ultrasonic Doppler were treated with LMWH by subcutaneous injection once every day for 7 - 10 days. All the patients were divided into 2 groups aceording to whether using LMWH or not：H group （ using LMWH） and N H group（ no using LMWH ）. It were detected before and after treatment that included thrombin time（TT） , activated partial thromboplastin time （APTT） , international normalized ratio（INR） , FIB, plasma mucosity ,erythrocyte sedimentation rate（ESR） ,hematocrit（HCT） and situation of haemorrhage. Results 1. Before treatment,PLT and FIB of patients in H group were significantly higher than those in NH group（Pα〈0.05 ）. 2. After treatment,ESR,plasma mucosity and FIB of patients in H group remarkably reduced than those of patients in NH group（ Pα〈 0.05 ）. 3. In H group, PLT, ESR, plasma mucosity and FIB of patients after treatment significantly decreased than those before treatment （Pα〈 0.05 ）. In NH group, ESR of patients after general treatment remarkably decreased than that before treatment（ Pα〈 0.05 ） ,but PLT,plasma mucosity and FIB of patients had not statistic difference between before and after general treatment. 4. PT,APTT and INR in both of two groups had not statistic difference before and after treatment. 5. One case of H group was found subcutaneous haemorrhage in the part of hypodermic injection which was absorbed after 4 d by fomenting. Others were not found side effects such as heavy haemorrhage and hypersusceptibility. Conclusion LMWH has many characteristics such as high bioavailability,well compliance, and few side effect, could ameliorate the hyp

关 键 词：低分子肝素 黏膜皮肤淋巴结综合征 高凝 疗效 

分 类 号：R725.4[医药卫生—儿科]