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目的探讨疏血通对系统性红斑狼疮并肺动脉高压患者临床症状、D-二聚体及凝血指标的影响。方法选择2013年5月—2015年8月本院收治的70例系统性红斑狼疮并肺动脉高压患者作为研究对象,随机分为对照组与观察组各35例。对照组患者接受激素联合环磷酰胺治疗,观察组患者在对照组治疗的基础上联合疏血通注射液治疗。比较两组患者治疗前后症状改善程度、D-二聚体及凝血指标的变化情况。计量资料组间比较采用t检验,组内比较采用配对t检验,计数资料采用χ~2检验,P<0.05为差异有统计学意义。结果观察组患者治疗后D-二聚体、凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶时间(thrombin time,TT)、纤维蛋白原(fibrinogen,FIB)水平分别为(556.89±21.20)ng/ml、(10.03±3.47)、(45.32±4.56)、(22.41±1.92)s、(6.03±0.88)g/L,与治疗前的(749.82±20.15)ng/ml、(11.23±2.43)、(48.36±3.12)、(27.70±2.91)s、(7.22±1.23)g/L相比均下降,差异均有统计学意义(均P<0.05)。对照组患者治疗后D-二聚体水平、TT、FIB水平分别为(621.97±26.04)ng/ml、(26.38±4.20)s、(6.78±1.49)g/L,与治疗前的(754.26±21.05)ng/ml、(28.37±3.36)s、(7.58±2.54)g/L相比均显著降低,差异均有统计学意义(均P<0.05)。观察组治疗后D-二聚体和TT、FIB水平均显著优于对照组,差异均有统计学意义(均P<0.05)。观察组患者治疗后症状改善率为77.1%,显著优于对照组的51.4%,差异有统计学意义(P<0.05)。结论疏血通联合激素和环磷酰胺治疗系统性红斑狼疮并肺动脉高压效果显著,能够有效改善患者的临床症状,降低病死率,值得临床推广使用。
Objective To investigate the effect of Shuxuetong on clinical symptoms, D-dimer and coagulation index in patients with systemic lupus erythematosus and pulmonary hypertension. Methods From May 2013 to August 2015, 70 patients with systemic lupus erythematosus and pulmonary hypertension treated in our hospital were randomly divided into control group and observation group (35 cases each). Patients in the control group received hormones combined with cyclophosphamide. Patients in the observation group were treated with Shuxuetong injection on the basis of the control group. The changes of symptoms, D-dimer and coagulation index before and after treatment in both groups were compared. Measurement data were compared between groups using t test, the group was compared using paired t test, count data usingχ ~ 2 test, P <0.05 for the difference was statistically significant. Results After treatment, D-dimer, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrin The levels of fibrinogen (FIB) were (556.89 ± 21.20) ng / ml, (10.03 ± 3.47), (45.32 ± 4.56), (22.41 ± 1.92) s and (6.03 ± 0.88) g / (749.82 ± 20.15) ng / ml, (11.23 ± 2.43), (48.36 ± 3.12), (27.70 ± 2.91) s and (7.22 ± 1.23) g / L, all of which were statistically significant <0.05). The levels of D-dimer, TT and FIB in the control group were (621.97 ± 26.04) ng / ml, (26.38 ± 4.20) s and (6.78 ± 1.49) g / L, 21.05) ng / ml, (28.37 ± 3.36) s and (7.58 ± 2.54) g / L respectively. There were significant differences between the two groups (all P <0.05). The D-dimer, TT and FIB levels in the observation group were significantly better than those in the control group (all P <0.05). The symptom improvement rate of the observation group after treatment was 77.1%, which was significantly better than 51.4% of the control group, the difference was statistically significant (P <0.05). Conclusion Shuxuetong combined hormones and cyclophosphamide in the treatment of systemic lupus erythematosus and pulmonary hypertension have significant effect, can effectively improve the clinical symptoms and reduce mortality, it is worth promoting the use of the clinic.