低分子肝素钙对COPD合并肺心病患者心肺功能、BNP及炎症因子水平的影响

doi:10.3969/j.issn.1671-7171.2019.06.023

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摘要 【目的】探讨低分子肝素钙对慢性阻塞性肺疾病(COPD)合并肺心病患者心肺功能、脑利钠肽(BNP)及炎症因子水平的影响。【方法】选取2016年3月至2018年3月在本院诊治的97例COPD合并肺心病的患者,采用随机数表法分为观察组(49例)和对照组(48例)。对照组采用常规治疗方法,观察组在对照组的基础上加用低分子肝素治疗。比较两组患者治疗前后凝血功能、肺功能、血气指标、BNP和炎症因子水平。【结果】观察组患者的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血氧饱和度(SpO₂)、动脉血氧分压( PaO₂)、第一秒用力呼气容积(FEV1)、FEV1占用力肺活量比值(FEV1/FVC)和其比值的预测值(FEV1%)水平均明显高于对照组,D-二聚体(D-D)含量和动脉血二氧化碳分压( PaCO₂)明显低于对照组,其差异均有统计学意义(P<0.05);观察组患者的BNP、白介素6(IL-6)、肿瘤坏死因子-α(TNF-α)和超敏C-反应蛋白(hs-CRP)水平均明显低于对照组,其差异有统计学意义(P<0.05)。【结论】低分子肝素钙治疗COPD合并肺心病患者,可改善患者的心肺功能,降低患者的BNP水平和炎症反应,值得临床推广应用。

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关键词 ：肺疾病, 慢性阻塞性/并发症, 肺心病/药物疗法, 药用制剂

Abstract：【Objective】To investigate the effects of low molecular weight heparin calcium on cardiopulmonary function, BNP (brain natriuretic peptide) levels and inflammatory status in patients with COPD (chronic obstructive pulmonary disease) complicated with pulmonary heart disease. 【Methods】A total of 97 patients with COPD complicated with pulmonary heart disease who were treated in our hospital from March 2016 to March 2018 were randomly divided into the observation group (49 cases) and the control group (48 cases). The control group was treated with conventional treatment measures, and the observation group was treated with low molecular weight heparin on the basis of the control group. One week after treatment, the changes of coagulation function, lung function and blood gas index before and after treatment were observed. The BNP levels and inflammatory status of the two groups were analyzed before and after treatment. 【Results】The prothrombin time (PT), activated partial thromboplastin time (APTT), blood oxygen saturation (SpO₂), arterial oxygen partial pressure (PaO₂), one second forced expiratory volume (FEV1), the first-second forced expiratory volume occupancy capacity (FEV1/FVC) and one second rate (FEV1%) in the observation group were significantly higher than the control group. The D-dimer (DD) content and arterial blood carbon dioxide partial pressure were significantly lower than the control group; the difference between the two groups was statistically significant (P<0.05). Brain natriuretic peptide (BNP), interleukin 6 ( The levels of IL-6), tumor necrosis factor (TNF-α) and high-sensitivity C-reactive protein (hs-CRP) in the observation group were significantly lower than the control group, and the difference was statistically significant (P<0.05). 【Conclusion】Low molecular weight heparin calcium in patients with COPD complicated with pulmonary heart disease can improve cardiopulmonary function and reduce BNP levels and inflammatory response in patients.

Key words： Pulmonary Disease, Chronic Obstructive/CO Pulmonary Heart Disease/DT Pharmaceutical Preparations

收稿日期: 2019-03-15

PACS:

R563

引用本文:

陈德和, 张仕国, 唐山, 王俊, 罗熠. 低分子肝素钙对COPD合并肺心病患者心肺功能、BNP及炎症因子水平的影响[J]. 医学临床研究, 2019, 36(6): 1109-1111.
CHEN De-he, ZHANG Shi-guo, TANG Shan, et al. Effects of Low Molecular Weight Heparin Calcium on Cardiopulmonary Function, BNP Level and Inflammatory Status in COPD Patients with Pulmonary Heart Disease. JOURNAL OF CLINICAL RESEARCH, 2019, 36(6): 1109-1111.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2019.06.023 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2019/V36/I6/1109