实用老年医学

实用老年医学 ›› 2022, Vol. 36 ›› Issue (7): 680-683.doi: 10.3969/j.issn.1003-9198.2022.07.008

• 临床研究 • 上一篇    下一篇

异丙托溴铵联合低分子肝素钙治疗老年慢性阻塞性肺疾病伴肺源性心脏病病人的疗效研究

马小玉, 李鹏飞, 台娜, 赵岳, 苏洁雪, 安福成, 索爽   

  1. 102300 北京市,北京市门头沟区医院(首都医科大学门头沟教学医院)呼吸与危重症医学科
  • 收稿日期:2021-08-16 出版日期:2022-07-20 发布日期:2022-07-18
  • 基金资助:
    2018年度北京市医院管理局“青苗”人才计划

Study on the efficacy of ipratropium bromide combined with low molecular weight heparin calcium in elderly patients with chronic obstructive pulmonary disease and pulmonary heart disease

MA Xiao-yu, LI Peng-fei, TAI Na, ZHAO Yue, SU Jie-xue, AN Fu-cheng, SUO Shuang   

  1. Department of Pulmonary and Critical Care Medicine, Beijing Mentougou District Hospital, Beijing 102300, China
  • Received:2021-08-16 Online:2022-07-20 Published:2022-07-18

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摘要： 目的 探讨异丙托溴铵联合低分子肝素钙对老年COPD伴肺源性心脏病(肺心病)病人的心功能、肺功能及心肌酶谱的影响。 方法 前瞻性选取我院2019年1月至2020年7月收治的COPD伴肺心病病人80例,根据随机数表法将其分为对照组以及研究组,每组40例。对照组给予异丙托溴铵治疗,研究组给予异丙托溴铵+低分子肝素钙治疗,2组均连续治疗10 d。比较2组病人治疗前后的心功能、肺功能、血清肌酸激酶(CK)及肌酸激酶同工酶(CK-MB)水平的变化。观察并比较2组的临床治疗有效率及不良反应发生率。 结果 研究组治疗有效率为97.5%,显著高于对照组的77.5%(χ2=7.314,P<0.01)。治疗前,2组舒张末期心室容积(EDV)、收缩末期心室容积(ESV)、右心室射血分数(RVEF)、FEV1/FVC、FVC、呼气高峰流量(PEF)差异均无统计学意义(P>0.05);治疗后,2组病人的EDV、ESV均显著减少,RVEF、FEV1/FVC、FVC、PEF显著增加,且研究组上述指标改善情况均优于对照组(P＜0.05)。治疗前,2组血清CK、CK-MB水平差异均无统计学意义(P>0.05);治疗后,2组血清CK、CK-MB水平均显著下降,且研究组血清CK、CK-MB水平显著低于对照组(P＜0.001)。2组不良反应发生率差异无统计学意义(χ2=0.220,P=0.823)。 结论 异丙托溴铵联合低分子肝素钙治疗COPD伴肺心病病人疗效显著,对其心功能、肺功能改善效果较好,能够显著降低CK、CK-MB水平,且安全性较好。

关键词: 异丙托溴铵, 低分子肝素钙, 慢性阻塞性肺疾病, 肺源性心脏病, 肌酸激酶, 老年人

Abstract: Objective To investigate the effects of ipratropium bromide combined with low molecular weight heparin calcium on the cardiac function, pulmonary function and myocardial enzymogram in the elderly patients with chronic obstructive pulmonary disease (COPD) combined with pulmonary heart disease (PHD). Methods A total of 80 patients with COPD combined with PHD admitted to our hospital from January 2019 to July 2020 were prospectively enrolled, and were divided into control group and study group by random number table method, with 40 cases in each group. The control group was treated with ipratropium bromide, while the study group was treated with ipratropium bromide combined with low molecular weight heparin calcium. The heart function, lung function, serum levels of creatine kinase (CK) and CK-MB of the two groups were compared before and after treatment. The effective rate and the incidence rate of adverse reactions were observed and compared between the two groups. Results The effective rate of the study group was significantly higher than that of the control group (97.50% vs 77.5%, χ2=7.314, P<0.01). After treatment, the levels of end-diastolic ventricular volume (EDV), end-systolic ventricular volume (ESV), CK and CK-MB in both groups were significant lower, and the levels of right ventricular ejection fraction (RVEF), forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC), FVC and peak expiratory flow (PEF) in both groups were significantly higher than those before treatment, especially in the study group (P＜0.05). There was no significant difference in the incidence rate of adverse reactions between the two groups (χ2=0.220, P=0.823). Conclusions Ipratropium bromide combined with low molecular weight heparin calcium is effective in the treatment of the elderly patients with COPD and PHD, which can improve their heart function and lung function, and significantly reduce the levels of CK and CK-MB.

Key words: ipratropium bromide, low molecular weight heparin calcium, chronic obstructive pulmonary disease, pulmonary heart disease, creatine kinase, aged

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