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陈 朴,瞿纪静.低分子肝素治疗脓毒症疗效观察[J].浙江中西医结合杂志,2012,22(5):336-338
低分子肝素治疗脓毒症疗效观察
Therapeutic Effect of Low Molecular Weight Heparin on Sepsis
投稿时间:2011-10-16  
DOI:
中文关键词:  脓毒症 低分子肝素钙 C反应蛋白 前降钙素 血小板 凝血酶原时间
英文关键词:sepsis low molecular weight heparin C-reactive protein calcitonin platelet prothrombin time
基金项目:浙江省温州市卫生局立项课题 (No.2008100)
作者单位
陈 朴 温州医学院附属乐清医院危重症医学科 乐清 325600 
瞿纪静 温州医学院附属乐清医院危重症医学科 乐清 325600 
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中文摘要:
      目的: 观察低分子肝素治疗脓毒症的临床疗效。方法: 将60例脓毒症患者随机分成治疗 组和对照组, 每组30例。在相同常规治疗基础上, 治疗组加用低分子肝素钙皮下注射, 12h 1次, 共 7天。观察两组患者治疗前后急性生理学和慢性健康状况评分Ⅱ (APACHEⅡ), C反应蛋白 (CRP)、 降钙素原 (PCT)、 血小板计数 (PLT)、 凝血酶原时间 (PT)、 活化部分凝血活酶时间 (APTT) 及 纤维蛋白原 (FIB) 的变化; 统计两组ICU住院时间和28天病死率。结果: 治疗后7天, 治疗组 APACHEⅡ评分、 CRP、 PCT水平均低于对照组, 差异有统计学意义 (P<0.05); 治疗组血小板计数高 于对照组, 差异有统计学意义 (P<0.05); 两组治疗后PT、 APTT及FIB差异均无统计学意义 (P> 0.05); 治疗组ICU住院时间和28天病死率比对照组降低, 但两组比较差异无统计学意义 (P> 0.05)。结论: 低分子肝素可降低脓毒症患者的炎症反应, 改善患者凝血功能, 并有缩短ICU住院时 间、 降低脓毒症患者病死率趋势, 临床使用安全。
英文摘要:
      Objective: To observe the clinical efficacy of low molecular weight heparin in treatment of sepsis. Methods: Sixty sepsis patients were randomly divided into conventional treatment group and heparin group, 30 in each. The heparin group was percutaneously injected with heparin twice a day for 7 days based on the conven? tional therapy in the control group. APACHE II was scored and C-reactive protein(CRP), plasma calcitonin(PCT), platelet(PLT), prothrombin time(PT), activated partial thromboplastin time(APTT), and fibrinogen(FIB) were detected before and after treatment. Stay in ICU and 28-d mortality were calculated in both groups. Results: After treat? ment, compared with the control group, APACHE II scores and the levels of CRP and PCT were lower(P<0.05), PLT was higher(P<0.05) in the heparin group, while the levels of PT, APTT, and FIB were the same between the 2 groups(P>0.05). Stay in ICU was shorter and the 28-day mortality was lower in the heparin group than those in the control group without a significant difference between them(P>0.05). Conclusion: Low molecular weight heparin can attenuate inflammation and improve coagulation in sepsis patients. This may result in reduction of stay in ICU and mortality.
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