摘要
目的观察慢性阻塞性肺疾病急性加重期(AECOPD)患者应用华法林抗凝治疗的可行性及安全性。方法前瞻性按纳入标准选择2016年1~12月广州市白云区人民医院内科AECOPD患者200例,采用隐匿数字随机法分为对照组和观察组各100例,对照组入院后给予常规治疗至病情缓解出院,观察组患者除给予常规治疗外,另给予华法林治疗3个月,入院时、治疗4周后检测肺功能、血气分析和D-二聚体,记录住院时间。所有患者均随访至2017年9月,比较两组患者的出血情况、死亡率及再次平均入院天数。结果观察组患者治疗后第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占用力肺活量比值(FEV1/FVC)分别为(1.19±0.32)L、(56.83±10.96)%,明显高于对照组的(1.04±0.29)L、(51.14±10.42)%,且明显高于治疗前的(0.94±0.28)L、(46.87±8.93)%,D-二聚体水平、二氧化碳分压(PaCO_2)分别为(357.65±42.71)ng/mL、(55.43±4.76)mmHg,明显低于对照组的(536.42±74.19)ng/mL、(59.36±5.71)mmHg,且低于治疗前的(688.93±84.72)ng/mL、(65.97±7.91)mmHg,差异均有统计学意义(P<0.05);观察组患者平均住院时间为(12.31±1.53)d,短于对照组的(15.24±2.06)d,差异有统计学意义(P<0.05);观察组患者的出血发生率为6.0%,略高于对照组的0;观察组的死亡率为2.0%,略低于对照组的6.0%,但两组比较差异均无统计学意义(P>0.05);观察组患者的平均再次住院时间为(8.27±2.46)d,明显短于对照组的(12.62±2.73)d,差异有统计学意义(P<0.05)。结论 AECOPD患者多存在血栓前状态,只要定期监测国际标准化比值,应用华法林治疗是可行且有效的。
Objective To observe the feasibility and safety of warfarin anticoagulant therapy for patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods From January 2016 to December 2016, 200 AECOPD patients from the People＇s Hospital of Guangzhou Baiyun District were randomly assigned into two groups to receive conventional therapy （the control group, n=100） and warfarin anticoagulant therapy plus conventional therapy （the observation group, n=100）, for 3 months. The lung function, blood gas analysis, D-dimers, and length of hos- pital stay were recorded at admission and after treatment for 4 weeks. All patients were followed up to September 2017. The bleeding, mortality, and average rehospitalization time of the two groups were compared. Results The forced expi- ratory volume in 1 s （FEV1）, ratio of forced expiratory volume in 1 s and forced vital capacity （FEV1/FVC） were （1.19± 0.32） L, （56.83±10.96）% in the observation group after treatment, significantly higher than the corresponding （1.04±0.29） L, （51.14±10.42）% in the control group and （0.94±0.28） L, （46.87±8.93）% before treatment （P〈0.05）. D-dimer levels, CO2 partial pressure （PaCO2） were （357.65±42.71） ng/mL, （55.43±4.76） mmHg in the observation group after treatment, significantly lower than the corresponding （536.42±：74.19） ng/mL, （59.36±5.71） mmHg in the control group and （688.93±84.72） ng/mL, （65.97±7.91） mmHg before treatment （P〈0.05）. The mean length of hospital stay was （12.31 ± 1.53） d in the observation group versus （15.24±2.06） d in the control group （P〈0.05）. The incidence of bleeding, mortali- ty were 6.0%, 2.0% in the observation group versus 0, 6.0% in the control group （P〉0.05）. The average rehospitalization time was （8.27±2.46） d in the observation group, significantly shorter than （12.62±2.73） d in the control group （P〈0.05）. Conclusion Patients with AECOPD are more likely to
作者
文倩
陈春玲
杨淑群
WEN Qian, CHEN ChuM-ling, YANG Shu-qun(First Department of Internal Medicine, the People ＇s Hospital of Guangzhou Baiyun District, Guangzhou 510500, Guangdong, CHIN)
出处
《海南医学》
CAS
2018年第6期760-762,共3页
Hainan Medical Journal
基金
广东省广州市白云区科技计划项目(编号:2016-KZ-048)
关键词
慢性阻塞性肺疾病急性加重期
华法林
可行性
安全性
Acute exacerbation of chronic obstructive pulmonary disease （AECOPD）
Warfarin
Feasibility
Safety
