慢性阻塞性肺疾病急性加重期抗凝治疗的疗效观察

目的：探讨在慢性阻塞性肺疾病急性加重期（AECOPD）应用低分子肝素钙抗凝治疗对患者肺功能、动脉血气分析和凝血功能的影响。方法80例患者按随机原则分为对照组42例和抗凝组38例。对照组患者给予吸氧、抗感染、解痉平喘、止咳化痰治疗，抗凝组在对照组常规治疗的基础上加用低分子肝素钙4100IU／次，腹壁皮下注射，每12h 1次。二组均7d为1个疗程。二组均于治疗前后检测肺功能、动脉血气分析和凝血功能。结果二组肺功能、血气分析在治疗7d后较治疗前均有改善（ P均＜0．01），但抗凝组较对照组改善更明显（P均＜0．01）；治疗后抗凝组的D -D含量及凝血指标（INR、PT、APTT、FIB）改善均显著优于治疗前（P均＜0．01）和对照组（P均＜0．01），而对照组治疗前后比较改善程度差异无统计学意义（P均＞0．05）。抗凝组不良反应发生率与对照组比较差异无统计学意义（P＞0．05）。结论应用低分子肝素钙抗凝治疗AECOPD ，在改善患者凝血功能的同时能更好的改善患者的肺功能、提高有效率。

CLINICAL OBSERVATION OF ANTICOAGULANT INTERVENTION IN THE TREATMENT OF ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Objective To investigate the intervention of low molecular weight heparin on lung function and coagulation function of patients experiencing acute exacerbation of chronic obstructive pulmonary disease （COPD） .Methods Eighty patients were randomly divided into control group （ 42 cases） and anticoagula-tion group （38 cases） .The control group was treated with oxygen inhalation ,antibiotics ,antispasmodic asthma ,relieving cough and phlegm .While the anticoagulation group received low molecular weight hepa-rin 4100 IU once time every 12 hours by abdominal subcutaneous injection addition to that of control group . Seven days were considered as a course of treatment in both groups .All patients received pulmonary func-tion and blood coagulation testing before and after treatment .Results After treatment ,lung function and arterial blood gas indices were significantly improved in both groups （allP 〈0 .01） ,but the patients in an-ticoagulation group were improved more significantly than the control group（all P 〈0 .01） .Anticoagula-tion treatment greatly improved the plasma D-dimer （D-dimer ,DD） content and the coagulation parame-ters in anticoagulation group （all P 〈0 .01） ,comparing with that of control group （allP 〈0 .01） ,while the control group did not produce significant improvement after treatment （all P 〉0 .05） .Occurrence rate of adverse reactions of anticoagulation group compared with the control group was no significant difference （P〉0 .05） .Conclusion Anticoagulant therapy of low molecular weight heparin with AECOPD is able to improve the blood coagulation ,moreover is better to improve the lung function and effective percentage .