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目的探讨低分子肝素(LMW)对老年慢性阻塞性肺疾病(COPD)急性加重期患者血浆内皮素(ET)的影响。方法老年COPD急性加重期患者62例,随机分为研究组(30例)和观察组(32例),观察组给予常规治疗(卧床休息、持续低流量吸氧、抗感染、解痉平喘、袪痰止咳等),研究组在常规治疗的基础上加用LMW0.4IU,皮下注射,每日1次,疗程为10d,观察治疗前、后血浆ET的变化,并与健康查体者做对照。观察患者治疗前、后临床症状变化。结果研究组和观察组血浆ET水平均比健康对照组显著升高(P<0.01);研究组治疗后血浆ET水平均显著下降(P<0.01),观察组治疗后血浆ET水平均明显下降(P<0.05),治疗后两组患者血浆ET水平有显著性差异(P<0.05)。研究组临床疗效明显好于观察组,两组总有效率差异有统计学意义(P<0.05)。结论 LMW治疗老年COPD急性加重期能够显著降低血浆ET水平,并有效改善临床疗效。
Objective To investigate the effect of low molecular weight heparin (LMW) on plasma endothelin (ET) in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods Sixty-two elderly patients with acute exacerbation of COPD were randomly divided into study group (n = 30) and observation group (n = 32). The observation group was given routine treatment (bed rest, continuous low-flow oxygen inhalation, anti-infection, antispasmodic and asthma, Cough, etc.), the study group on the basis of conventional treatment plus LMW0.4IU, subcutaneous injection, once daily for 10d, observed before and after treatment of plasma ET changes, and with physical examination were compared. Observed before and after treatment of patients with clinical symptoms. Results The levels of plasma ET in study group and observation group were significantly higher than those in healthy control group (P <0.01). The levels of plasma ET in study group were significantly decreased (P <0.01), and ET level in observation group was significantly decreased P <0.05). There was significant difference in plasma ET levels between the two groups after treatment (P <0.05). The clinical efficacy of the study group was significantly better than that of the observation group, with a significant difference between the two groups in total effective rate (P <0.05). Conclusion LMW treatment of elderly patients with acute exacerbation of COPD can significantly reduce plasma ET levels, and effectively improve the clinical efficacy.