低分子肝素钙对肺源性心脏病心力衰竭患者临床疗效及血浆N-末端脑钠肽前体、D-二聚体水平的影晌

目的：观察低分子肝素钙对肺源性心脏病（肺心病）心力衰竭患者血液流变学、血浆N-末端脑钠肽前体（NT-proBNP）及D-二聚体（D-D）水平的影响。方法选取2011年1月-2014年1月肺心病心力衰竭患者95例，随机分为观察组45例及对照组50例。2组均给予常规治疗，观察组在此基础上加用低分子肝素钙皮下注射。观察2组临床疗效、不良反应、治疗前后血液流变学、血浆NT-proBNP及D-D水平的变化。结果治观察总有效率95．56％，显著高于对照组总有效率82．00％（P＜0．05），2组不良反应无显著差异（P＞0．05）；2组治疗后血液流变学、血浆NT-proBNP及D-D水平均较治疗前显著改善（P＜0．05或P＜0．01）；观察组显著优于对照组（P＜0．05或P＜0．01）。结论低分子肝素钙联合多巴酚丁胺和硫酸镁治疗肺心病心力衰竭患者安全有效，可显著改善患者血液流变学指标，降低血浆NT-proBNP及D-D水平。

Clinical effects of low molecular heparin calcium on N-terminal pro-brain natriuretic peptide and blood plasma D-dipolymer level in heart failure patients with pulmonary heart disease

Obj ective To observe the clinical effects of low molecular heparin calcium on hemorheology,N-terminal pro-brain natriuretic peptide （NT-proBNP）and blood plasma D-dipoly-mer （D-D）level in heart failure patients with pulmonary heart disease.Methods 95 heart failure patients with pulmonary heart disease were randomly divided into observation （n= 45 ）and control groups （n= 50）,both treated with regular treatment.Extra hypodermic injection of low molecular heparin calcium was given to observation group.Clinical effects,adverse events,hemorheology,N-terminal pro-brain natriuretic peptide （NT-proBNP）and blood plasma D-dipolymer （D-D）level were observed.Results Effective rate in observation group （95 .56%）was significantly higher than in control group （82.00%）（P〈0.05）,and significant difference was found in adverse events. Hemorheology,N-terminal pro-brain natriuretic peptide （NT-proBNP）and blood plasma D-dipoly-mer （D-D）level were improved in both groups after treatment （P〈0.05,P〈0.01）,and differ-ences between 2 groups were significant （P〈0.05,P〈0.01）.Conclusion Low molecular hep-arin calcium combined with dobutamine and magnesium sulfate has the potential to improve the hemorheology,N-terminal pro-brain natriuretic peptide （NT-proBNP）and blood plasma D-dipoly-mer （D-D）level in heart failure patients with pulmonary heart disease.