肝素雾化吸入对慢性阻塞性肺疾病患者痰液黏稠度的影响  

The impact of heparin atomization inhalation on sputum viscosity of COPD patients

作　　者：周静[1] 陈华丽[1] 李军文[1] 田培刚[1] 玛丽亚[1] 程青虹[1] 

机构地区：[1]石河子大学医学院第一附属医院护理部,新疆石河子832008

出　　处：《中国急救医学》2014年第5期395-399,共5页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨雾化吸入肝素对于慢性阻塞性肺疾病（COPD）患者改进痰液性状，促进痰液排出的有效性。方法研究设计为随机的、前瞻性的、双盲的及临床干预的对照研究。以60例COPD患者为研究对象。随机分为肝素组、沐舒坦组和0．45％氯化钠溶液组（每组各20例）。三组均采用氧气雾化吸入给药方法。三组于不同时间点检测痰液的α1-酸性糖蛋白、Ca2＋含量及pH值。结果肝素组、沐舒坦组痰液成分中α1-酸性糖蛋白、Ca2＋含量随着雾化时间的延长逐渐减少，pH升高，与0．45％氯化钠溶液组比较差异有统计学意义（P〈0．05）；肝素组与沐舒坦组两组痰液成分中α-酸性糖蛋白含量比较差异无统计学意义（P〉0．05），但雾化肝素组的Ca2＋逐渐降低，pH值随着雾化时间的延长逐渐升高至平稳状态，与沐舒坦组比较差异有统计学意义（P〈0．05）；直观三组药物随着雾化时间的延长均表现出痰液黏稠度的显著降低，且肝素组优于0．45％氯化钠溶液和沐舒坦组，差异有统计学意义（P〈0．05），但与客观衡量指标相比，有一定的差异。结论雾化吸入肝素、0．45％氯化钠溶液和沐舒坦都能降低COPD患者痰液的黏稠度，肝素、沐舒坦的效果要优于0．45％氯化钠溶液，而肝素作用似乎更有优势。Objective To explore the suitable medicine for the chronic obstructive pulmonary disease （COPD） patients treated by aerosol inhalation and effectually promote the excretion of sputum. Methods Sixty COPD patients from ICU were collected for this prospective and double - blind clinical study. They were divided into three groups equally and randomly, named as Heparin Group, Ambroxol Group and 0.45% NaCl Group. They were all treated through the method of aerosol inhalation. Ambroxol Group and 0.45% NaCl Group are the control groups to Heparin Group. Heparin, ambroxol and 0.45% NaCl were selected as the medicines for these patients. Their effect on the patients＇sputum is characterized in terms of α - acid glycoprotein, Ca2＋ and pH. Results When the patients were treated by heparin and ambroxol, the contents of α - acid glycoprotein and Ca2＋ decreased and pH value increased, both of which was different from those obtained from 0.45% NaC1 statistically （ P 〈 0.05 ）. There was no statistical difference in the contents of et - acid glycoprotein and Ca2 ~ between heparin and ambroxol group （P 〉 0.05 ）. But the pH value of the patients treated by heparin gradually increased to a plateau, different from the situation of ambroxol （ P 〈 0.05 ）. No matter what kind of medicine was used, the visual sputum viscosity would have decreased statistically. And heparin group was more effective than the other two groups （ P 〈 0. 05 ） Conclusion Aerosol inhalation of 0. 45% NaCl, ambroxol and heparin could decrease the viscosity of COPD patient＇s sputum. But heparin and ambroxol are more effective than 0.45% NaCl in the reducing of the sputum viscosity. The change in visual suptum viscosity over the experiment period has a considerable difference with those from the detailed parameters. Aerosol inhalation of heparin is safe to the COPD patients.

关 键 词：雾化吸入 痰液黏稠度 肝素 慢性阻塞性肺疾病(COPD) 沐舒坦 

分 类 号：R563.05[医药卫生—呼吸系统]