低分子肝素皮下注射对慢性阻塞性肺疾病急性加重期的疗效观察  

Curative Effect Observation of Subcutaneous Injection of Low Molecular Weight Heparin on Acute Exacerbation of Chronic Obstructive Pulmonary Disease

作　　者：段勇弟 DUAN Yongdi(Jianli Hospital of Traditional Chinese Medicine,Hubei Province,Jianli 433300,China)

机构地区：[1]湖北省监利市中医医院,湖北监利433300

出　　处：《中国医学创新》2023年第3期61-65,共5页Medical Innovation of China

摘　　要：目的:观察低分子肝素皮下注射对慢性阻塞性肺疾病急性加重期(AECOPD)的疗效,为临床治疗提供参考。方法:选取监利市中医医院2020年8月-2021年12月收治的60例AECOPD患者为对象,根据简单随机法分为两组。对照组给予常规对症治疗,观察组在对照组基础上给予低分子肝素钠皮下注射。比较两组患者治疗前、治疗后改良英国医学研究学会呼吸困难指数(mMRC)评分、血气指标、血管性血友病因子(vWF)、内皮素-1(ET-1)、白细胞介素-32(IL-32)、D-二聚体(D-D)、纤维蛋白原(Fib)水平,并统计两组治疗总有效率。结果:观察组的总有效率为93.33%(28/30),高于对照组的70.00%(21/30),差异有统计学意义(P<0.05)。治疗前,两组血气指标、vWF、ET-1、IL-32、D-D、Fib比较,差异均无统计学意义(P>0.05);治疗后,观察组动脉血氧分压(PaO2)、血氧饱和度(SaO2)均高于对照组,vWF、ET-1、IL-32、D-D、Fib、二氧化碳分压(PaCO_(2))均低于对照组(P<0.05)。治疗前,两组m MRC评分比较,差异无统计学意义(P>0.05);治疗后,观察组mMRC评分低于对照组(P<0.05)。结论:低分子肝素皮下注射治疗AECOPD可改善患者血气指标,降低vWF、ET-1、IL-32、D-D、Fib的表达水平,缓解呼吸困难,提高治疗效果。Objective: To observe the curative effect of subcutaneous injection of low molecular weight heparin on acute exacerbation of chronic obstructive pulmonary disease(AECOPD) and provide reference for clinical treatment. Method: A total of 60 patients with AECOPD admitted to Jianli Hospital of Traditional Chinese Medicine from August 2020 to December 2021 were selected and divided into two groups according to simple random method.The control group was given routine symptomatic treatment, and the observation group was given subcutaneous injection of Low Molecular Weight Heparin Sodium on the basis of the control group. The modified British Medical Research Council dyspnea index(mMRC) scores, blood gas indicators, von willebrand factor(vWF), endothelin-1(ET-1), interleukin-32(IL-32), D-dimer(D-D) and fibrinogen(Fib) levels before and after treatment were compared between the two groups, and the total effective rates of the two groups were calculated. Result: The total effective rate of the observation group was 93.33%(28/30), which was higher than that of the control group [70.00%(21/30)], the difference was statistically significant(P<0.05). Before treatment, there were no significant differences in blood gas indexes, vWF, ET-1, IL-32, D-D and Fib between the two groups(P>0.05). After treatment, the arterial partial pressure of oxygen(PaO2) and saturation of blood oxygen(SaO2) of the observation group were higher than those of the control group, while the vWF, ET-1, IL-32, D-D, Fib and partial pressure of carbon dioxide(PaCO2) of the observation group were lower than those of the control group(P<0.05). Before treatment, there was no significant difference in mMRC score between the two groups(P>0.05). After treatment, the mMRC score of the observation group was lower than that of the control group(P<0.05). Conclusion: Subcutaneous injection of low molecular weight heparin in the treatment of AECOPD can improve blood gas indicators of patients, reduce the expression levels of vWF, ET-1, IL-32, D-D and Fib, relieve dyspn

关 键 词：低分子肝素 慢性阻塞性肺疾病急性加重 动脉血气 血管性血友病因子 呼吸困难指数 

分 类 号：R563.9[医药卫生—呼吸系统]