肝素在慢性乙型肝炎治疗中的应用  

The usage of heparin in the treatment of patients with chronic hepatitis B.

作　　者：郝菁华[1] 石军 任万华 韩国庆 朱菊人 王万忠 王书运[4] 谢英渤[4] 

机构地区：[1]青岛大学医学院附属医院消化科,山东青岛266003 [2]山东省医院肝病中心,山东济南250021 [3]山东省医院病理科,山东济南250021 [4]山东师范大学电镜室,山东济南250014

出　　处：《临床肝胆病杂志》2002年第2期109-110,共2页Journal of Clinical Hepatology

摘　　要：观察肝素／低分子量肝素改善肝脏微循环的疗效，探讨其作用机制、剂量、疗程及不良反应。３４例慢性 乙型肝炎患者随机分为Ａ、Ｂ两组。Ａ组１２例，给予常规治疗；Ｂ组２２例，在常规治疗的基础上加用肝素／低分子 量肝素，其中１２例应用肝素，１０例应用低分子量肝素。每位患者用药至少两周。治疗前后分别检测肝功能、血清 透明质酸（ＨＡ）水平、ＡＴ－Ⅲ活性。Ｂ组中有５例患者在治疗前后分别行肝活组织检查。治疗半月前后，Ａ、Ｂ二组 ＡＬＴ、ＰＴ水平下降，但无统计学意义。Ｂ组ＨＡ水平显著下降。肝素组与低分子量肝素组相比，ＡＴ－Ⅲ活性显著 下降。与治疗前相比，治疗后肝细胞肿胀减轻，肝窦腔通畅，毛细胆管淤胆减轻。肝素／低分子量肝素可以改善肝 脏微循环，短期应用无明显不良反应。低分子量肝素应用更安全。To study the effect of heparin/low molecule weight heparin (LMWH) on hepatic microcirculation in patients with chronic hepatitis B, 34 cases were divided into two groups. Group A, including 12 cases, was taken regular regi- men. While group B, including 22 cases, was given heparin/LWWH,in addition to regular regimen. Hepatic functions, serum hyaluronate (HA) levels, and AT - Ⅲ ectivities were measured before and after treatment, respectively. 5 cases in group B were taken liver biopsy twice. Compared with group A, HA, D - Dimer, HCT levels in group A were decreased significantly AT - Ⅲ activities were decreased much more obviously in patients taking heparin than those taking LMWH. After using heparin/LMWH for two weeks, liver cells were less swollen, the sinusoids were clear, and cholesta- sis were lessened. Heparin/LMWH can improve the hepatic microcirculation without marked side effects. Compared with heparin, LMWH was safer and more convenient.

关 键 词：肝脏 微循环 肝素 低分子量肝素 乙型肝炎 治疗 

分 类 号：R512.62[医药卫生—内科学]