Influences of low molecular weight heparin therapy on lung function, coagulation function and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease complicated with lung cancer
10.3760/cma.j.cn.115807-20220710-00183
- VernacularTitle:低分子肝素治疗对急性加重期慢阻肺合并肺癌患者肺功能、凝血功能及预后的影响
- Author:
Guoshi WAN
1
;
Xuping LUO
;
Jiahui ZHENG
Author Information
1. 杭州市余杭区第二人民医院呼吸内科，杭州 311121
- Keywords:
Lung cancer;
Acute exacerbation of chronic obstructive pulmonary disease;
Low molecular weight heparin;
Coagulation function
- From:
Chinese Journal of Endocrine Surgery
2023;17(4):494-498
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the influences of low molecular weight heparin therapy on lung function, coagulation function and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease complicated with lung cancer.Methods:Sixty patients with acute exacerbation of chronic obstructive pulmonary disease complicated with lung cancer were gathered and randomly grouped into a routine group (30 cases) and a heparin group (30 cases). The patients in the routine group were given symptomatic treatment, and the patients in the heparin group were given low molecular weight heparin treatment on the basis of the symptomatic treatment, 4 100 iu/12 h. The coagulation function [activated partial thromboplastin time (APTT), prothrombin time (PT), D-dimer], blood gas analysis indexes [blood oxygen saturation (SaO 2), carbon dioxide partial pressure (PaCO 2), blood oxygen partial pressure (PaO 2) ], vascular endothelial function [nitric oxide (NO), endothelin 1 (ET-1), intercellular adhesion molecule-1 (ICAM-1) ], lung function [forced expiratory volume in first second (FEV1), forced vital capacity (FVC), ratio of FEV1 to predicted value (FEV1%) ], C-reactive protein (CRP), dyspnea (mMRC score) and survival were compared. Results:Compared with those before treatment, the levels of APTT [ (18.46±1.87) vs (11.58±1.25) s, (18.11±1.82) vs (15.57±1.58) s],PT[ (29.53±3.01) vs (22.57±2.36) s, (29.14±2.93) vs (25.48±2.61) s], D-dimer [ (842.59±85.12) vs (435.62±44.57) g/L, (846.63±84.75) vs (551.79±55.64) g/L],PaCO 2[ (58.79±5.92) vs (42.53±4.26) mmHg, (59.14±5.96) vs (50.38±5.07) mmHg],ET-1[ (106.78±10.72) vs (65.37±6.64) ng/L, (105.96±10.61) vs (72.53±7.31) ng/L],ICAM-1[ (231.48±23.35) vs (142.63±14.57) μg/L, (228.79±23.12) vs (165.48±16.72) μg/L], CRP [ (80.39±18.53) vs (9.77±2.08) mg/L, (80.64±19.17) vs (14.86±3.16) mg/L] and mMRC [ (2.64±0.31) vs (1.42±0.22) points, (2.71±0.34) vs (1.78±0.27) points] in both groups were greatly decreased after treatment ( P<0.05), and compared with the routine group, the heparin group were greatly lower ( P<0.05). Compared with those before treatment, the levels of SaO 2[ (0.54±0.15) vs 0.82±0.24) mmHg, (0.56±0.16) vs (0.67±0.20) mmHg],PaO 2[ (56.32±5.65) vs (80.47±8.12) mmHg, (56.89±5.72) vs (72.13±7.25) mmHg],NO[ (54.31±5.46) vs (96.78±10.02) μmol/L, (53.27±5.35) vs (85.64±8.62) μmol/L],FEV1[ (1.21±0.32) vs (1.89±0.45) %, (1.25±0.34) vs (1.57±0.41) %],FVC[ (3.41±0.35) vs (3.78±0.42) L, (3.37±0.32) vs (3.56±0.36) L],FEV1%[ (80.74±8.15) vs (88.46±8.75) %, (79.53±8.02) vs (83.82±8.41) %] in the two groups after treatment were greatly increased ( P<0.05), and compared with the routine group, the heparin group were greatly increased ( P<0.05). A 3-year follow-up of the patients showed that there were 11 survivors in the heparin group (accounting for 36.67%), which was more than that of the conventional group (7 survivors, accounting for 23.33%) ( χ2=8.310, P=0.004) . Conclusion:Low molecular weight heparin can effectively enhance the coagulation function, pulmonary function and vascular endothelial function, regulate blood gas indexes, ameliorate dyspnea in patients with acute exacerbation of chronic obstructive pulmonary disease and lung cancer, and improve patient prognosis.
