[关键词]
[摘要]
目的 探讨还原型谷胱甘肽联合低分子肝素治疗慢性肺心病急性加重期的临床效果。方法 选取2018年1月-2019年1月南阳医学高等专科学校第二附属医院收治的慢性肺心病急性加重期患者129例,随机分为对照组(64例)和治疗组(65例)。对照组皮下注射低分子肝素注射液,5 000 AXa/次,2次/d。治疗组在对照组的基础上静脉滴注注射用还原型谷胱甘肽,1.5 g加入生理盐水100 mL,1次/d。两组患者治疗2周。观察两组患者临床疗效,同时比较治疗前后两组患者动脉血二氧化碳分压(pCO2)、血氧分压(pO2)和动脉血氧饱和度(SaO2)指标,左室射血分数(LVEF)、每搏输出量(SV)、心输出量(CO)、1秒用力呼吸容积(FEV1)、呼吸流量峰值(PEF)、肺活量(FVC)、血细胞比容、血红蛋白、D-二聚体、纤维蛋白原、血过氧化脂质(LPO)、丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)和氧化氢酶(CAT)水平。结果 治疗后,对照组和治疗组临床有效率分别为79.70%和92.31%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者pCO2、血细胞比容、血红蛋白、D-二聚体、纤维蛋白原、LPO、MDA水平较治疗前显著降低(P<0.05),pO2、SaO2、LVEF、SV、CO、FEV1、PEF、FVC、SOD、GSH-Px及CAT水平较治疗前显著升高(P<0.05),且治疗组患者这些指标明显好于对照组(P<0.05)。结论 还原型谷胱甘肽联合低分子肝素治疗慢性肺心病急性加重期临床疗效确切,可改善患者临床症状及心肺功能,并改善血液黏稠度及机体抗氧化能力。
[Key word]
[Abstract]
Objective To investigate the clinical effect of reduced glutathione combined with low molecular weight heparin in treatment of acute exacerbation of chronic pulmonary heart disease. Methods Patients (129 cases) with acute exacerbation of chronic pulmonary heart disease in the Second Affiliated Hospital of Nanyang Medical College from January 2018 to January 2019 were randomly divided into control (64 cases) and treatment (64 cases) groups. Patients in the control group were subcutaneous injection administered with Low Molecular Weight Heparin Calcium Injection, 5 000 AXa/time, twice daily. Patients in the treatment group were iv administered with Reduced Glutathione for injection on the basis of the control group, 1.5 g added into normal saline 150 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the pCO2, pO2 SaO2, LVEF, SV, CO, FEV1, PEF, FVC, hematocrit, hemoglobin, D-dimer, fibrinogen, LPO, MDA, SOD, GSH-Px and CAT levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 79.70% and 92.31%, respectively, and there were differences between two groups (P<0.05). After treatment, the pCO2, hematocrit, hemoglobin, D-dimer, fibrinogen, LPO, MDA levels in two groups were significantly decreased (P<0.05), but the pO2, SaO2, LVEF, SV, CO, FEV1, PEF, FVC, SOD, GSH-Px and CAT levels were significantly increased (P<0.05), and these indexes in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Reduced glutathione combined with low molecular weight heparin in treatment of acute exacerbation of chronic pulmonary heart disease has definite clinical efficacy, can improve the clinical symptoms and cardiopulmonary function, and improve blood viscosity and antioxidant capacity.
[中图分类号]
R974
[基金项目]