低分子肝素钙对慢性肺源性心脏病急性加重期临床研究  

Clinical study on the effect of LMWH on acute stage of chronic pulmonary heart disease

作　　者：蔡宇星 吴正霞[1] 张春峰[1] 张和平[1] 陈凯[1] 

机构地区：[1]宝鸡市中心医院呼吸科,陕西宝鸡72100

出　　处：《临床肺科杂志》2012年第3期433-434,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的观察低分子肝素钙(LMWH)对继发于COPD的肺心病急性加重期患者肺动脉压(PASP)及六分钟步行试验(6MWT)的影响。方法将152例继发于COPD的肺心病急性加重期患者,随机分为LMWH治疗组及对照组,两组均给予控制感染、氧疗等常规治疗,LMWH治疗组加用LMWH皮下注射10天。记录两组入院及住院10天时PASP及6MWT结果。结果治疗10天后,治疗组PASP下降明显,差异具有统计学意义(u=3.37,P<0.01);治疗组6MWT距离增加明显,差异具有统计学意义(u=3.47,P<0.01)。结论 LMWH对继发于COPD的肺心病急性加重期可明显降低PASP,提高6 MWT距离。Objective To observe the effect of the Low-molecular-weight Heparins Calcium （LMWH） on the PASP and 6-minute walk test （6MWT） of the patients,who were diagnosed as the acute stage of chronic pulmonary heart disease secondary to COPD. Methods One hundred and fifty-two patients diagnosed as acute stage of chronic pulmonary heart disease secondary to COPD were randomly divided into two groups： LMWH-treated group and the control group. All the cases were treated with conventional treatment including anti-in- fection, oxygen therapy, bronchodilator, dispelling Phlegm, etc. The LMWH was subeutaneous injected to the LMWH-treated group besides the routine treatment. The PASP （ unit ： mmHg） was tested in all patients by color Doppler echocardiography, and the 6-minute walk test（6MWT） （unit：meter） when they were admitted to hospital and 10 days after hospitalization respeetively. Results Ten days later, The PASP of the LMWH-treated group was（29.88 ±9.55 ）, while the control group （35.17± 9.8 ）. There was a statistically significant difference between the two groups（ u = 3.37, P 〈 0. 01 ）. The distance of 6MWT of the LMWH-treated group was （251.97±65.80）, while the control group（ 217. 16±57.63 ）. There was a statistically significant difference between the two groups （ u = 3.47, P 〈 0. 01 ）. Conclusions The Low-molecular-weight Heparins Calcium （LMWH） can remarkably reduce the PASP and improve the distance of 6MWT of the patients, who are diagnosed as the acute stage of chronic pulmonary heart disease secondary to chronic obstructive pulmonary disease （ COPD）.

关 键 词：慢性阻塞性肺疾病(COPD) 慢性肺源性心脏病 低分子肝素(LMWH) 肺动脉压(PASP) 六分钟步行试验(6MWT) 

分 类 号：R541.5[医药卫生—心血管疾病]