低分子肝素对脓毒血症患者凝血功能的影响  

Effects of low molecular weight heparin on coagulation function in patients with sepsis

作　　者：宋爱琳 SONG Ai-lin(Dalian Friendship Hospital,Dalian 116001,China)

机构地区：[1]大连市友谊医院重症一病房,116001

出　　处：《中国现代药物应用》2022年第11期27-30,共4页Chinese Journal of Modern Drug Application

摘　　要：目的通过皮下注射低分子肝素的方式进行抗凝治疗,观察其对脓毒血症患者凝血功能的影响。方法40例脓毒血症患者,随机分为观察组和对照组,各20例。对照组患者给予常规治疗措施,观察组在对照组的基础上采用皮下注射低分子肝素钙抗凝治疗。比较两组患者血流动力学参数[平均动脉压(MAP)、中心静脉血氧饱和度(ScvO2)、系统血管阻力指数(SVRI)]、凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)]、血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]。结果观察组患者的MAP(11.48±1.01)kPa、ScvO2(76.29±7.93)%均高于对照组的(10.79±0.79)kPa、(62.31±6.08)%,SVRI(1659.02±130.69)dyn·s/(cm^(5)·m^(2))低于对照组的(1971.30±142.98)dyn·s/(cm^(5)·m^(2)),差异有统计学意义(P<0.05)。观察组患者的APTT(31.65±4.89)s、TT(15.89±1.94)s、PT(13.38±1.16)s均长于对照组的(28.29±4.39)、(13.74±1.16)、(11.17±1.05)s,差异有统计学意义(P<0.05)。观察组患者的IL-6(130.81±10.79)ng/L、TNF-α(30.19±9.87)ng/L、CRP(34.79±5.89)mg/L均低于对照组的(149.33±11.41)ng/L、(69.74±14.01)ng/L、(46.14±11.98)mg/L,差异均具有统计学意义(P<0.05)。结论通过皮下注射低分子肝素的方式进行抗凝治疗,可以显著降低患者的血栓风险,防止诱发急性血栓性疾病,并且对改善炎症反应,更加利于患者的恢复,可以广泛推荐使用。Objective To observe the effect of subcutaneous injection of low molecular weight heparin on coagulation function in patients with sepsis.Methods A total of 40 patients with sepsis were randomly divided into observation group and control group,with 20 cases in each group.Patients in the control group received conventional treatment measures,and patients in the observation group received subcutaneous injection of low molecular weight heparin calcium for anticoagulation on the basis of the control group.Both groups were compared in terms of hemodynamic parameters[mean arterial pressure(MAP),central venous oxygen saturation(ScvO2),systemic vascular resistance index(SVRI)],coagulation function indexes[activated partial thromboplastin time(APTT),thrombin time(TT),prothrombin time(PT)],serum inflammatory markers[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)].Results The MAP(11.48±1.01)kPa and ScvO2(76.29±7.93)%of the observation group were higher than(10.79±0.79)kPa and(62.31±6.08)%of the control group,and the SVRI(1659.02±130.69)dyn·s/(cm^(5)·m^(2))was lower than(1971.30±142.98)dyn·s/(cm^(5)·m^(2))of the control group.All the differences were statistically significant(P<0.05).The APTT(31.65±4.89)s,TT(15.89±1.94)s,and PT(13.38±1.16)s of the observation group were longer than(28.29±4.39),(13.74±1.16),and(11.17±1.05)s of the control group,and the differences were statistically significant(P<0.05).The levels of IL-6(130.81±10.79)ng/L,TNF-α(30.19±9.87)ng/L and CRP(34.79±5.89)mg/L in the observation group were lower than(149.33±11.41)ng/L,(69.74±14.01)ng/L,and(46.14±11.98)mg/L in the control group,and the differences were statistically significant(P<0.05).Conclusion Anticoagulant therapy by subcutaneous injection of low molecular weight can significantly reduce the risk of thrombosis,prevent the induction of acute thrombotic disease,and improve the inflammatory reaction.It is more conducive to the recovery of patients,and can be widely recommended.

关 键 词：脓毒血症 低分子肝素 血流动力学 凝血功能 炎性指标 

分 类 号：R459.7[医药卫生—急诊医学]