COPD患者实施抗栓预防治疗应用低分子肝素的效果分析及纤维蛋白原的改变情况分析  

Effects of antithrombotic prophylaxis with low molecular heparin and changes of fibrinogen in COPD patients

作　　者：毛小青 马文江[2] 

机构地区：[1]浙江省景宁县人民医院呼吸科,浙江丽水323500 [2]浙江大学医学院附属第一医院呼吸科,浙江杭州310003

出　　处：《中国医院药学杂志》2015年第15期1414-1417,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的:探讨对慢性阻塞性肺疾病患者应用低分子肝素治疗的临床效果及对纤维蛋白原的改变情况,为临床治疗COPD患者提供参考建议。方法:将180例COPD患者随机分为治疗组和对照组各90例,对照组采用COPD疾病常规治疗方法,治疗组在对照组的基础上加用低分子肝素皮下注射(5 000 IU,bid)。比较2组患者治疗前与治疗1周后血气分析指标、平均肺动脉压、纤溶指标、血液流变学指标、临床效果差异。结果:治疗组和对照组治疗后较治疗前p(O2)、p(CO2)、mPAP均显著改善且差异具有统计学意义(P<0.05);治疗组治疗后FBG、PT、TT、全血黏度、红细胞压积较治疗前均显著好转且差异均具有统计学意义(P<0.05),对照组治疗后FBG、PT、TT、全血黏度、红细胞压积较治疗前差异不显著(P>0.05);2组治疗后p(O2)、mPAPFBG、PT、TT、全血黏度、红细胞压积比较,治疗组改善优于对照组且差异具有统计学意义(P<0.05);治疗组治疗后显效率为60%,显著高于对照组的36.67%,无效率为6.67%,显著低于对照组的15.56%,治疗组的总有效率为93.33%明显高于对照组的84.44%,且差异均具有统计学意义(P<0.05)。结论:采用低分子肝素联合常规治疗对COPD患者进行综合治疗能够显著提高临床疗效及相关临床指标的改善率。OBJECTIVE To explore clinical effects of low molecular heparin in patients with chronic obstructive pulmonary disease （COPD） and changes of fibrinogen, provide references for clinical treatment of patients with COPD. METHODS A total of 180 COPD patients were randomly divided into treatment group and control, group. Patients were treated by routine treatment in control group, and low molecular weight heparin plus routine therapy in treatment group （5 000 IU, 2 times/day）. Blood gas analysis, mean arterial pressure, fibrinolysis, hemorheology and clinical effects were compared between two groups. RESULTS Treatment group and control group had significantly changed p （O2）, p （CO2） and mPAP （P〈0. 05）. In treatment group, FBG, PT, TT, whole blood viscosity, hematocrit were significantly improved （P〈0. 05） after treatment. In control group, FBG, PT, TT, whole blood viscosity and hematocrit had not changed significantly after treatment （P〉0. 05）. After treatment, P （O2）, mPAPFBG, PT, TT, whole blood viscosity and hematocrit were improved more obviously in treatment group than in control group （P〈0. 05）. Efficacy rate in treatment group （60%） was obviously higher than control group （36. 67%）, ineffective rate in treatment group （6. 67%） was obviously lower than control group （15.56%）. The total effective rate was 93.33% in treatment, which was significantly higher than that in control group （84. 44） （P〈0. 05）. CONCLUSION Low molecular weight heparin combined with conventional treatment can significantly improve clinical efficacy and relevant clinical indicators in COPD patients.

关 键 词：慢性阻塞性肺疾病 低分子肝素 纤维蛋白原 

分 类 号：R969[医药卫生—药理学]