Clinical research of anticoagulant intervention in the treatment of acute exacerbation of chronic obstructive pulmonary disease / 中国综合临床

ABSTRACT

Objective To investigate the intervention of low molecular weight heparin on lung function and coagulation function of patients experiencing acute exacerbation of chronic obstructive pulmonary disease (COPD).Methods Senventy patients,hospitalized in our department from 2009 -2010,with acute exacerbation of COPD,were randomly divided into control group ( 32 patients) and anticoagulation group ( 38 patients).The control group was treated with oxygen inhalation,antibiotics,antispasmodic asthma,relieving cough and phlegm.The anticoagulation group received low molecular weight heparin 4100 IU AXa/times by abdominal subcutaneous injection at 12 h intervals addition to that of control group.Ten days were considered as a course of treatment in both groups.All patients received pulmonary function and blood coagulation testing before and after treatment.Results After treatment,lung function and arterial blood gas indices were significantly improved in both groups ( the anticoagulation groupt =8.2064,6.9207,9.4351,7.5845,7.5241 ; the control group t =5.5588,3.0795,3.9374,2.8488,2.7726,all P ＜ 0.01 ),but the patients in anticoagulation group were improved more significantly than the control group( t =3.2732 4.0167,7.3392,2.2528,3.0008,Pall ＜ 0.01 ) ;anticoagulation treatment greatly improved the plasma D-dimer ( D-dimer,DD) content and the coagulation parameters in anticoagulation group ( comparing with that before treatment,t =5.721,23.235,25.318,23.841,11.354,Pall ＜ 0.01 ; comparing with that of control,t =7.738,19.365,23.373,21.008,9.712,Pall ＜ 0.01 ),while the control group did not produce significant improvement after treatment (t =1.9409,8.0000,1.1592,1.6562,1.2726,P all ＞ 0.05 ).There were had no serious adverse reactions in the anticoagulation treatment group.Conclusion Although the conventional treatment can improve the symptoms of the patients with COPD,but it can't effectively improve the patient's blood hypercoagulability.Conventional therapy combined with low molecular weight heparin anticoagulant therapy is able to improve the blood coagulation hence the lung function in COPD patients.