舒洛地特注射液与低分子肝素在急性呼吸窘迫综合征患者中的应用效果比较  

Comparison of the efficacy of sulodexide injection and low molecular weight heparin in acute respiratory distress syndrome patients

作　　者：彭卫 柳舟[1] 侯彦广 李镇文 江贵军 石昭坤 张召才[2] 宋振举 詹丽英[1] 李光[1] PENG Wei;LIU Zhou;HOU Yanguang;LI Zhenwen;JIANG Guijun;SHI Zhaokun;ZHANG Zhaocai;SONG Zhenju;ZHAN Liying;LI Guang(Dept.of Critical Care Medicine,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China;Dept.of Critical Care Medicine,The Second Affiliated Hospital,Zhejiang University School of Medicine&Zhejiang Province Clinical Research Center for Emergency and Critical Care Medicine,Hangzhou 310009,Zhejiang,China;Dept.of Emergency,Zhongshan Hospital Fudan University&Institute of Emergency Rescue and Critical Care,Fudan University,Shanghai 200032,China)

机构地区：[1]武汉大学人民医院重症医学科,湖北武汉430060 [2]浙江大学医学院附属第二医院重症医学科/浙江省急危重症临床医学研究中心,浙江杭州310009 [3]复旦大学附属中山医院急诊科/复旦大学应急救援与急危重症研究所,上海200032

出　　处：《武汉大学学报(医学版)》2025年第2期181-186,198,共7页Medical Journal of Wuhan University

基　　金：国家重点研发计划(编号:2021YFC2501800);国家自然科学基金面上项目(编号:82272226);广东省二十一世纪教育基金会项目(编号:2023HX0054);武汉市知识创新专项项目(编号:2023020201010165);武汉大学人民医院交叉创新人才项目(编号:JCRCYG⁃2022⁃005;JCRCZN⁃2022⁃017)。

摘　　要：目的:比较舒洛地特(SDX)注射液和低分子肝素(LMWH)应用在急性呼吸窘迫综合征(ARDS)患者中的安全性及疗效。方法:纳入2020年4月—2024年4月于武汉大学人民医院重症医学科住院的ARDS患者共40例,根据实际用药分为舒洛地特(SDX)组(20例)和低分子肝素(LMWH)组(20例)。采用独立样本t检验、Mann-Whitney U检验及卡方检验等统计学方法比较两组患者在一般资料、总住院时间、ICU住院时间、机械通气时间、血常规、凝血功能、肝功能指标及血气结果上的差异。结果:两组患者一般情况、总住院时间及ICU住院时间的比较差异无统计学意义(P>0.05)。与LMWH组相比,SDX组患者的机械通气时间减少(P<0.05)。两组患者在用药后活化部分凝血活酶时间(APTT)均有延长,LMWH组患者治疗后纤维蛋白原(FIB)降低,SDX组患者治疗后白蛋白升高,两组患者给药后均出现红细胞计数(RBC)降低、血红蛋白(Hb)减少以及动脉血氧饱和度(SaO2)降低(P<0.05)。两组患者给药前后丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、血小板计数(PLT)、D-二聚体对比差异均无统计学意义(P>0.05)。结论:相较于使用低分子肝素,ARDS患者使用舒洛地特注射液能够降低机械通气时间,且不会引起肝功能损伤、血小板降低等不良反应。Objective:To compare the safety and efficacy of sulodexide(SDX)versus low molecular weight heparin(LMWH)in patients with acute respiratory distress syndrome(ARDS)through a retrospective study.Methods:A retrospective cohort study included 40 ARDS patients hospitalized in the Depart-ment of Critical Care Medicine at Renmin Hospital of Wuhan University from April 2020 to April 2024.According to the actual medication,patients were divided into two groups:the SDX group(20 cases)and the LMWH group(20 cases).General conditions,total length of hospital stay,length of ICU stay,mechanical ventilation time,as well as blood routine,coagulation function,liver function,and blood gas results were compared between the SDX group and the LMWH group.Results:There was no statistically significant difference in the general conditions,total hospitalization time,and ICU stay between the two groups(P>0.05).Compared with those in the LMWH group,the mechanical ventilation time of patients in the SDX group was reduced(P<0.05).Activated partial thromboplas-tin time(APTT)was prolonged in both groups after drug administration,fibrinogen(FIB)was de-creased in patients in the LMWH group,and albumin was increased in patients in the SDX group after treatment.A decrease in red blood cell count(RBC),a reduction in hemoglobin(Hb),and a decrease in blood oxygen saturation(SaO2)were observed in both groups after drug administration(P<0.05).No statistically significant changes were found in alanine aminotransferase(ALT),aspartate amino-transferase(AST),platelet count(PLT),and D-dimer after drug administration in both groups(P>0.05).Conclusion:Compared with the low molecular weight heparin,sulodexide injection in pa-tients with ARDS reduces the duration of mechanical ventilation and does not cause adverse effects such as hepatic impairment and platelet reduction.

关 键 词：急性呼吸窘迫综合征 低分子肝素 舒洛地特注射液 疗效 安全性 

分 类 号：R459.7[医药卫生—急诊医学]