肺心病血栓前状态及抗凝干预疗效分析

目的　探讨肺心病患者的血栓前状态 ,并观察分析低分子肝素抗凝干预的价值 ;方法　将肺心病患者4 6例分为低分子肝素治疗组和常规治疗组各 2 3例 ,分别检测治疗前后血浆血管性假血友病因子 (vWF)、血浆凝血酶片段 1+2 (F1+ 2 )、纤维蛋白原 (Fg)、血小板颗粒膜蛋白 (GMP - 14 0 )和D -二聚体 (DD) ;结果　肺心病患者vWF、F1+ 2 、Fg、GMP - 14 0、DD血浆浓度显著高于对照组 ;肺心病治疗组经LMWH治疗后上述各凝血分子标记物及PaCO2 明显降低 ,而PaO2 显著增高 ,而常规组虽血气指标略有改善 ,而凝血分子标志物未见改善 ;结论　尽早检测诊断肺心病血栓前状态 ,及时给予低分子肝素抗凝干预 ,有望从根本上改善肺心病急性加重期患者的不良预后

Analysis of pre-thrombosis state in patients with chronic cor pulmonale and anticoagulant treatment

Objective To study pre-thrombosis state in patients with cor pulmonale and analyze the value of treatment with low molecular heparin (LMH). Method 46 patients with cor pulmonale were divided into LMH group and routine one. Von Willebrand factor (vWF), prethrombin F 1+2 fragment (F 1+2 ), Fibrinogen (Fg), granule membrane protein (GMP-140) and D-dimer fragment (DD) were detected separately.Result The concentrations of WF,F 1+2 ,Fg,GMP-140 and DD in the patients with cor pulmonale were significantly higher than control. In LMH group, these variables and PaCO 2 decreased and PaO 2 increased markedly after treatment. In routine group, these blood-gas index slightly improved, but no decrease were observed in coagulation variables. Conclusion Early detection and diagnosis of pre-thrombosis state in patients with cor polmanate and timely treatment with LMH can be beneficial to these patients during acute state.