老年COPD合并肺心病急性发作期的抗凝治疗  

Anticoagulant treatment in senile patients with chronic obstructive pulmonary disease and pneumocardial disease

作　　者：宋雅君[1] 周哲慧[1] 柳耀康 饶世明[1] 黄颖俊 

机构地区：[1]上海市黄浦区中心医院内科,上海200002

出　　处：《临床肺科杂志》2011年第10期1500-1501,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨低分子肝素在治疗老年COPD合并肺心病急性发作期的疗效。方法收集50例老年肺心病急性加重期患者,随机分为低分子肝素治疗组和常规组各25例,治疗前和用药后第7 d分别采血测定凝血功能;纤维蛋白原;D-二聚体;血液流变学指标,包括红细胞压积、全血粘度、血浆粘度(高切、低切);以及肺动脉收缩压(SPAP)、氧分压、二氧化碳分压等指标。结果治疗组及常规组病人经治疗后病情均有明显好转,治疗组临床疗效明显优于常规组且不良反应少。结论老年COPD合并肺心病患者,了解其血栓前状态,并通过低分子肝素抗凝治疗,降低肺动脉栓塞的发病率,降低高死亡率,且不良反应少。Objective To study the value of treatment with low molecular heparin（LMWH） in senile patients with chronic obstructive pulmonary disease and pneumocardial disease.Methods 50 senile patients with chronic obstructive pulmonary disease and pneumocardial disease at acute episode phase were divided into LMWH group and routine one.The plasma coagulation parameters of prothombin time,partial thromboplastin time,thrombin time,fibrinogen,D-dimer,the hemorheological indexes of hematocrit,blood viscosity,plasma viscosity,PaO2,PaCO2 and pulmonary arterial pressure were determined separately.Result The curative effect was better in LMWH group than that in routine group without side effect.In LMWH group,FBG,D-dimer,HCT,BV,PV,SPAP,PaCO2 decreased and PaO2 increased more markedly than routine group after treatment.But no obvious changed in the plasma coagulation between LMWH group and routine group.Conclusion Early detection and diagnosis of pre-thrombosis state in senile patients with chronic obstructive pulmonary disease and pneumocardial disease and timely treatment with LMWH can be benefical to these patients during acute state without side effect.

关 键 词：慢性阻塞性肺疾病 肺心病 低分子肝素 

分 类 号：R541.5[医药卫生—心血管疾病] R563.9[医药卫生—内科学]