低分子肝素聯合乙酰半胱氨酸治療特發性間質性肺炎的療效

來源:用戶上傳      作者:華明磊 劉曉敏 薛婧

　　摘 要：目的 分析特l性間質性肺炎（idiopathic interstitial pneumonias，IIP）患者采取低分子肝素聯合乙酰半胱氨酸的治療效果。方法 回顧性選取2018年1月～2021年1月棗莊市立醫院新城院區呼吸內科收治的60例IIP患者作為研究對象，根據治療方法不同分成研究組與常規組，每組30例。常規組患者采取常規治療聯合低分子肝素注射液，研究組患者在常規組治療基礎上聯合應用乙酰半胱氨酸片。比較兩組患者的治療效果，治療前后血清Ⅲ型膠原、高分辨率CT（HRCT）病變評分、6 min步行距離，動脈血二氧化碳分壓（PaCO2）、動脈血氧分壓（PaO2）、用力肺活量（FVC）、第一秒用力呼氣量（FEV1）以及一秒率（FEV1/FVC），不良反應發生情況。結果 研究組患者的總有效率明顯高于常規組，差異有統計學意義（P<0.05）。治療后，研究組與常規組患者的PaO2高于治療前，PaCO2低于治療前，差異有統計學意義（P<0.05）;且研究組患者PaO2高于常規組，PaCO2低于常規組，差異有統計學意義（P<0.05）。治療后，兩組患者HRCT病變評分與血清Ⅲ型膠原低于治療前，6 min步行距離高于治療前，差異有統計學意義（P<0.05）;且研究組患者HRCT病變評分與血清Ⅲ型膠原低于常規組，6 min步行距離高于常規組，差異有統計學意義（P<0.05）。治療后，兩組患者FEV1、FVC及FEV1/FVC均高于治療前，差異有統計學意義（P<0.05）;且研究組患者上述各指標高于常規組，差異有統計學意義（P<0.05）。兩組患者不良反應發生率的差異無統計學意義（P>0.05）。結論 IIP患者采取低分子肝素注射液聯合乙酰半胱氨酸片治療，可提高治療效果，對患者的肺功能、動脈血氣指標改善較為明顯，且安全性較好，值得應用。
　　關鍵詞：醋酸潑尼松片;乙酰半胱氨酸;低分子肝素;特發性間質性肺炎;肺功能
　　中圖分類號：R249 文獻標識碼：A 文章編號：1009-8011（2022）-6-000-04
　　The Therapeutic Effect of Low Molecular Weight Heparin Combined with Acetylcysteine in
　　Patients with Idiopathic Interstitial Pneumonia
　　HUA Ming-lei1 LIU Xiao-min1 XUE Jing2*
　?。?.Respiratory department of Xincheng branch of Zaozhuang Municipal Hospital， Shandong
　　Zaozhuang， 277300， China;
　　2.Department of Pharmacy， Medical Supplies Center of PLA General Hospital， Beijing， 100039， China）
　　Abstract： Objective To analyze the therapeutic effect of low molecular weight heparin combined with acetylcysteine in patients with idiopathic interstitial pneumonia. Methods Sixty patients with idiopathic interstitial pneumonia， who were admitted to the Department of Respiratory Medicine， Xincheng District， Zaozhuang Municipal Hospital from January 2018 to January 2021， were retrospectively selected as the study subjects， and divided into the study group and the conventional group according to different treatment methods， with 30 patients in each group. Patients in the conventional group received conventional treatment combined with low molecular weight heparin， and on the basis of the routine group， the treatment regimen of the research group was given low molecular weight heparin injection combined with acetylcysteine tablets. The adverse study and therapeutic effects were compared between the study group and the conventional group. Serum collagen type Ⅲ， HRCT lesion score， 6min walking distance， arterial partial pressure of carbon dioxide （PaCO2）， arterial partial pressure of oxygen （PaO2） forced vital capacity （FVC）， first second forced end-expiratory volume （FEV1）， and FEV1/FVC were compared before and after treatment between the study group and the conventional group. Results The total effective rate of the study group was 96.67%， higher than that of the conventional group 70.00% （P<0.05）. The PaO2 of the study group was higher than that of the conventional group， while PaCO2 was lower than that of the conventional group （P<0.05）. After treatment， the HRCT lesion score and serum type Ⅲ collagen in the study group were lower than those in the conventional group， and the 6min walking distance was higher than that in the conventional group （P<0.05）. After treatment， patients in FEV、 FVC and FEV1/FVC group were higher than those in conventional group （P<0.05）. The incidence of adverse reactions was 3.33% in the study group and 6.67% in the conventional group （P>0.05）. Conclusion For patients with idiopathic interstitial pneumonia， low molecular weight heparin combined with acetylcysteine can effectively improve the therapeutic effect， lung function and arterial blood gas indicators of patients are significantly improved， which is worthy of wide application.

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