参芎葡萄糖治疗慢性阻塞性肺疾病合并肺源性心脏病的临床效果  

Clinical Effect of Shenqiong Glucose on Chronic Obstructive Pulmonary Disease Complicated with Pulmonary Heart Disease

作　　者：郑玉强 宋竹翠 王宁 崔朝勃 ZHENG Yuqiang;SONG Zhucui;WANG Ning;CUI Chaobo(Department of Respiratory and Critical Care Medicine,Hengshui People's Hospital,Hengshui,Hebei 053000,China)

机构地区：[1]衡水市人民医院呼吸与危重症医学科,河北衡水053000

出　　处：《临床误诊误治》2024年第8期88-94,共7页Clinical Misdiagnosis & Mistherapy

基　　金：关于下达2018年衡水市科技计划(2018014027Z)。

摘　　要：目的探讨参芎葡萄糖治疗慢性阻塞性肺疾病(COPD)合并肺源性心脏病(PHD)的临床效果。方法选取2022年1月—2024年1月收治的228例COPD合并PHD,采用随机数字表法随机将其分为观察组和对照组2组各114例。观察组给予参芎葡萄糖联合常规治疗,对照组给予常规治疗。比较2组血常规指标(红细胞、血红蛋白、红细胞比容、血小板计数)、凝血指标[D-二聚体(D-D)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB)]、肝肾功能[血尿素(BUN)、血肌酐(Scr)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、总蛋白(TP)]、血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动脉血氧饱和度(SaO_(2))]、心型脂肪酸结合蛋白(H-FABP)、肌钙蛋白I(cTnI)、N末端B型脑钠肽前体(NT-proBNP)、肺动脉收缩压(PASP)、急性生理学及慢性健康状况评估系统Ⅱ(APACHEⅡ)评分,并统计入院28 d病死情况、治疗期间不良反应。结果治疗后,2组红细胞、血红蛋白、红细胞比容、血小板计数、D-D、FIB、PaCO_(2)、H-FABP、cTnI、NT-proBNP、PASP、APACHEⅡ低于治疗前,且观察组低于对照组;2组PT、APTT、PaO_(2)、SaO_(2)高于治疗前,且观察组高于对照组(P<0.05,P<0.01)。治疗前后,2组组间和组内BUN、Scr、AST、ALT、TP比较无明显差异(P>0.05)。观察组入院28 d病死率和治疗期间不良反应发生率(7.02%,8/114;7.89%,9/114)与对照组(10.53%,12/114;5.26%,6/114)比较无明显差异(P>0.05)。结论参芎葡萄糖可改善COPD合并PHD患者血常规、凝血指标及血气指标,并降低H-FABP、cTnI、NT-proBNP水平,进而减轻心肌损伤程度,缓解患者病情。Objective To investigate the clinical effect of combined therapy with Shenqiong glucose on chronic obstructive pulmonary disease(COPD)complicated with pulmonary heart disease(PHD).Methods A total of 228 patients with COPD complicated with PHD were selected from January 2022 to January 2024 and randomly divided into observation group(n=114)and control group(n=114)by random number table method.The observation group was given Shenqiong glucose combined with conventional treatment,and the control group was given conventional treatment.Blood routine(erythrocyte,erythrohemoglobin,hematocrit,platelet count),coagulation indexes[D-dimer(D-D),prothrombin time(PT),activated partial thromplastin time(APTT),fibrinogen(FIB)],liver and kidney function[blood urea nitrogen(BUN),serum creatinine(Scr),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total protein(TP)],blood gas indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),arterial oxygen saturation(SaO_(2))],heart-type fatty acid-binding protein(H-FABP),cardiac troponin I(cTnI),N-terminal pro-B-type natriuretic peptide precursor(NT-proBNP),pulmonary artery systolic pressure(PASP),Acute Physiology And Chronic Health EvaluationⅡ(APACHEⅡ)scores were compared between the two groups.Additionally,28-day mortality after admission and adverse reactions during treatment were recorded.Results After treatment,erythrocyte,hemoglobin,hematocrit,platelet count,D-D,FIB,PaCO_(2),H-FABP,cTnI,NT-proBNP,PASP,APACHEⅡin the two groups were lower than those before treatment,and lower in the observation group than in the control group.PT,APTT,PaO_(2) and SaO_(2) in the two groups were higher than those before treatment,and higher in the observation group than in the control group(P<0.05,P<0.01).Before and after treatment,there were no significant differences in BUN,Scr,AST,ALT and TP between and within the two groups(P>0.05).There was no significant difference in 28-day mortality rate and the incidence of adverse reactions d

关 键 词：肺疾病 慢性阻塞性 合并症 肺源性心脏病 参芎葡萄糖 红细胞 活化部分凝血酶原时间 丙氨酸转氨酶 心型脂肪酸结合蛋白 

分 类 号：R563.9[医药卫生—呼吸系统]