血必净联合低分子肝素对老年严重脓毒血症患者凝血功能及血管内皮细胞促炎因子的影响

发布时间：2018-04-24 06:04

本文选题：脓毒血症 + 血必净　；参考：《中国老年学杂志》2016年22期

【摘要】：目的探讨血必净联合低分子肝素(LMWH)对老年严重脓毒血症患者凝血功能及血管内皮细胞促炎因子的影响。方法 60例老年严重脓毒血症患者随机分为血必净+LMWH组(A组)和常规治疗组(B组)。在常规治疗的基础上A组加用血必净注射液50 ml静脉滴注,2次/d,连续使用7 d,同时给予LMWH 0.3~0.6 ml皮下注射,1次/d,连续使用7 d。B组则在相同的时间给予同等量的0.9%Na Cl作为对照。在治疗前和治疗后7 d抽取两组静脉血检测活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、血浆D二聚体(DD)、血管细胞黏附分子(VCAM)-1、细胞间黏附分子(ICAM)-1、一氧化氮(NO)浓度水平。结果治疗后A组各凝血功能指标均较治疗前有所改善(P0.01),B组FIB、DD较治疗前有明显改善(P0.05)。治疗后A组APTT、FIB、DD凝血指标均较B组治疗后改善更为明显(P0.05);治疗后A组ICAM-1和NO较治疗前有所下降(P0.05),B组VCAM-1和ICAM-1较治疗前有所提高(P0.05)。治疗后A组VCAM-1、ICAM-1和NO均较B组有所下降(P0.05)。结论血必净联合LMWH能够明显改善老年严重脓毒血症患者的凝血功能,稳定血管内皮细胞,减轻严重炎性反应。
[Abstract]:Objective to investigate the effects of Xuebijing combined with low molecular weight heparin (LMWHs) on coagulation function and vascular endothelial cell inflammatory factor (VEGF) in elderly patients with severe sepsis. Methods 60 elderly patients with severe sepsis were randomly divided into Xuebijing LMWH group (group A) and routine treatment group (group B). On the basis of routine therapy, group A was treated with 50 ml Xuebijing injection intravenously for 2 times / d, continuously for 7 days, at the same time, LMWH 0.3g / 0.6 ml was subcutaneously injected for 1 / d, and 7 d.B group was given the same amount of 0.9%Na Cl at the same time as control group. The concentrations of activated partial thromboplastin time (APTTT), prothrombin time (PTT), fibrinogen (FIBN), plasma D-dimer (D-dimer), vascular cell adhesion molecule (VCAM-1), intercellular adhesion molecule (ICAM-1) and nitric oxide (no) were measured before and 7 days after treatment. Results after treatment, the coagulation function indexes in group A were improved compared with those before treatment. FIBDD in group B was significantly improved than that before treatment. After treatment, the coagulation indexes of group A were significantly improved than that of group B (P 0.05), and the levels of ICAM-1 and no in group A were lower than those before treatment. The levels of VCAM-1 and ICAM-1 in group A were higher than those in group B (P 0.05). After treatment, the levels of ICAM-1 and no in group A were lower than those in group B (P 0.05). Conclusion Xuebijing combined with LMWH can significantly improve coagulation function, stabilize vascular endothelial cells and alleviate severe inflammatory reaction in elderly patients with severe sepsis.
【作者单位】：江苏大学附属武进医院ICU;
【基金】：常州市武进区科技局社会发展基金资助项目(No.WS2011014)
【分类号】：R459.7

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