低分子肝素对ICU脓毒症患者ALI/ARDS氧合指数及炎症反应的影响观察  

Effect of Low Molecular Weight Heparin on Oxygenation Index and Inflammatory Reaction of Sepsis Patients with ALI/ARDS in ICU

作　　者：周红瑜 陶静[1] 盖磊 颜碧清[1] Zhou Hongyu;Tao Jing;Gai Lei;Yan Biqing(ICU,Affiliated Hospital of Medical College of Ningbo University,Zhejiang Ningbo 315000,China)

机构地区：[1]宁波大学医学院附属医院ICU,浙江宁波315000

出　　处：《中国药师》2019年第1期106-108,共3页China Pharmacist

摘　　要：目的:观察低分子肝素(LMWH)对重症监护病房(ICU)脓毒症患者急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)氧合指数(OI)及炎症反应的影响。方法:脓毒症性ALI/ARDS患者64例随机分为对照组(常规治疗+LMWH2 500 U)与观察组(常规治疗+LMWH 5 000 U),每组各32例,均连续治疗7 d。比较两组治疗前后的PaO_2/FiO_2、炎症反应[肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)]、凝血功能[凝血酶原时间(PT)、部分凝血活酶时间(APPT)]、急性生理与慢性健康(APACHE)Ⅱ评分,观察药品不良反应。结果:治疗7 d后,观察组PaO_2/FiO_2较前显著升高,炎症介质(TNF-α、IL-6)水平、APACHEⅡ评分较前显著降低(P <0. 05);且上述指标均明显优于对照组(P <0. 05)。两组凝血功能(PT、APTT)水平治疗前后无显著变化(P> 0. 05);药品不良反应发生率比较,差异无统计学意义(P> 0. 05)。结论:LMWH对ICU脓毒症患者ALI/ARDS的治疗有一定效果,LMWH可以提高机体氧合指数、降低炎症反应和APACHEⅡ评分,对凝血功能无明显影响,临床应用安全有效,值得进一步研究。Objective:To investigate the effect of low molecular weight heparin(LMWH)on oxygenation index and inflammatory reaction of sepsis patients with acute lung injury/acute respiratory distress syndrome(ALI/ARDS)in intensive care unit(ICU).Methods:Totally 64 sepsis patients with ALI/ARDS in ICU were selected and randomly divided into two groups with32 cases in each,namely the control group(the routine treatment+LMWH 2 500 U)and the observation group(the routine treatment+LMWH 5 000 U).The PaO2/FiO2,inflammatory factor levels[tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)],coagulation function[prothrombin time(PT),activated partial thromboplastin time(APPT)],acute physiology and chronic health evaluation(APACHE)Ⅱscore of the two groups were measured and compared.Results:After the 7-day treatment,the level of PaO2/FiO2 was significantly higher in the observation group than that in the control group,while the inflammatory factor levels(TNF-αand IL-6)and the APACHEII score of the observation group were lower than those of the control group(P<0.05).The coagulation function(PT and APPT)and the incidence of adverse reactions of the two groups had no significant differences(P>0.05).Conclusion:LMWH can effectively and safely increase oxygenation index,reduce inflammatory response and APACHEII score in sepsis patients with ALI/ARDS in ICU without influence on coagulation function,which is worthy of further studies.

关 键 词：低分子肝素 脓毒症 ALI/ARDS 氧合指数 炎症反应 

分 类 号：R973.2[医药卫生—药品]