摘要
目的探究糖皮质激素联合低分子肝素钠对慢性阻塞性肺疾病急性加重期(AECOPD)D-二聚体(D-D)水平升高者的疗效及对血清D-D、4-羟基壬烯醛(4-HNE)水平的影响。方法纳入2018年6月至2019年6月在武汉同济医院住院治疗的AECOPD患者100例作为研究对象。使用随机数字表法将患者分为对照组和观察组,每组50例,对照组在常规治疗基础上加用甲泼尼龙琥珀酸钠治疗,观察组在对照组基础上加用低分子肝素钠。观察两组患者临床疗效、肺功能、血气分析、不良反应、D-D和4-HNE水平。结果观察组的总有效率为90%,明显高于对照组的70%,差异有统计学意义(P<0.05)。两组患者治疗后第1秒用力呼气量(FEV1)、用力肺活量(FVC)、FEV1/FVC均较治疗前升高,且观察组明显高于对照组,差异有统计学意义(P<0.05)。治疗后观察组pH值、动脉血氧分压明显高于对照组,而动脉血二氧化碳分压明显低于对照组,差异均有统计学意义(P<0.05)。两组患者的D-D与4-HNE水平均较治疗前明显降低,差异有统计学意义(P<0.05)。治疗后观察组D-D水平明显低于对照组,差异有统计学意义(P<0.05)。但治疗后观察组4-HNE水平与对照组比较,差异无统计学意义(P>0.05)。两组均未出现严重不良反应。结论与单纯使用糖皮质激素相比,联合低分子肝素钠治疗D-D水平升高的AECOPD患者可提高临床疗效,进一步改善肺功能和动脉血气指标,降低D-D水平,且具有较高的安全性。
Objective To investigate the efficacy of the combination of glucocorticoid and low molecular weight heparin sodium in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and the influence on the level of D-Dimer(D-D)and 4-hydroxynonenal(4-HNE).Methods A total of 100 patients with AECOPD who were hospitalized in Wuhan Tongji Hospital from June 2018 to June 2019 were included as the study subjects.The patients were randomly divided into control group and observation group,50 cases in each group.The control group was treated with methylprednisolone on the basis of conventional treatment,and the observation group was treated with low molecular weight heparin sodium on the basis of the control group.The clinical effect,lung function,blood gas analysis,adverse reactions,blood D-D and blood 4HNE levels were observed.Results The total effective rate of the observation group was 90%,which was significantly higher than 70%of the control group,and the difference was statistically significant(P<0.05).After the treatment,FEV1,FVC and FEV1/FVC of the two groups were significantly higher than those before the treatment,and FEV1,FVC and FEV1/FVC of the observation group were significantly higher than those control group,and the differences were statistically significant(P<0.05).After the treatment,pH and PaO2 in the observation group were significantly higher than those in the control group,and PaCO2 was significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of D-D and 4-HNE in the two groups were significantly lower than those before treatment(P<0.05).After treatment,D-D in the observation group was significantly lower than that in the control group(P<0.05).However,there was no significant difference in the level of 4-HNE between the observation group and the control group after treatment(P>0.05).No serious adverse reactions occurred in both groups.Conclusion Compared with glucocorticoid alone,the combination of low molecular weight
作者
赵静
程青
钟强
ZHAO Jing;CHENG Qing;ZHONG Qiang(Department of Emergency,Taikang Tongji (Wuhan) Hospital,Wuhan,Hubei 430000,China;Department of Emergency,Wuhan Tongji Hospital,Wuhan,Hubei 430000,China)
出处
《国际检验医学杂志》
CAS
2020年第24期3037-3040,共4页
International Journal of Laboratory Medicine
关键词
慢性阻塞性肺疾病急性加重
D-二聚体
凝血功能
低分子肝素钠
4-羟基壬烯醛
acute exacerbation of chronic obstructive pulmonary disease
D-dimer
coagulation function
low molecular weight heparin sodium
4-hydroxynonenal
