低分子量肝素治疗重症急性胰腺炎研究进展

发布时间：2018-11-27 08:30

【摘要】：背景：重症急性胰腺炎是临床上较为常见的急腹症之一，是一种累及多个器官的全身性疾病，其发病快，进展迅速，治疗棘手，对其治疗干预措施也处于不断探索之中。重症急性胰腺炎发病机制的复杂性决定其治疗方式的复杂及多样性。低分子量肝素的抗凝作用显著，且副作用小，，目前被广泛应用于临床中。研究发现，低分子量肝素除了抗凝血、抑制血小板聚集等作用外，还具有改变血流变性、抗炎、调节细胞凋亡、调节脂质代谢等作用，可以通过干预重症急性胰腺炎发病病理生理过程产生治疗作用。目的：通过综述目前低分子量肝素治疗重症急性胰腺炎药理机制及临床疗效研究进展，为以后更进一步研究提供参考。方式：以“低分子量肝素，胰腺炎，重症急性胰腺炎”等关键词进行检索，对低分子量肝素治疗重症急性胰腺炎研究方面文献进行检索。结果：目前有大量关于低分子量肝素治疗重症急性胰腺炎方面研究，研究表明，低分子量肝素可能通过改善胰腺微循环、调节炎症反应、调节腺泡细胞凋亡、调节脂质代谢等途径在重症急性胰腺炎病情进展中发挥作用。重症急性胰腺综合治疗联合使用低分子量肝素可能改善患者的预后、降低并发症发生率及死亡率，而并不增加出血风险。
[Abstract]:Background: severe acute pancreatitis (SAP) is one of the most common acute abdomen diseases. It is a systemic disease involving multiple organs. The complexity of the pathogenesis of severe acute pancreatitis determines the complexity and diversity of its treatment. Low-molecular weight heparin (LMWH) is widely used in clinic because of its remarkable anticoagulant effect and low side effect. In addition to anticoagulant and platelet aggregation inhibition, low molecular weight heparin (LMWH) also has the effects of changing blood rheology, anti-inflammation, regulating cell apoptosis, regulating lipid metabolism, etc. Intervention in the pathophysiological process of severe acute pancreatitis may have therapeutic effects. Objective: to review the pharmacological mechanism and clinical efficacy of low molecular weight heparin (LMWH) in the treatment of severe acute pancreatitis (SAP). Methods: the key words "low molecular weight heparin, pancreatitis and severe acute pancreatitis" were used to search the literature on the treatment of severe acute pancreatitis with low molecular weight heparin. Results: there has been a lot of research on the treatment of severe acute pancreatitis with low molecular weight heparin. The research shows that low molecular weight heparin may regulate the apoptosis of acinar cells by improving pancreatic microcirculation, regulating inflammatory reaction and regulating acinar cell apoptosis. Regulation of lipid metabolism plays an important role in the progression of severe acute pancreatitis. Combined use of low molecular weight heparin for severe acute pancreas therapy may improve the prognosis, reduce the incidence of complications and mortality, but do not increase the risk of bleeding.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R657.51

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