摘要
目的 探讨参芎葡萄糖治疗慢性阻塞性肺疾病(COPD)合并肺源性心脏病(PHD)的临床效果.方法 选取2022 年1 月—2024 年1 月收治的228 例COPD合并PHD,采用随机数字表法随机将其分为观察组和对照组2 组各114 例.观察组给予参芎葡萄糖联合常规治疗,对照组给予常规治疗.比较2 组血常规指标(红细胞、血红蛋白、红细胞比容、血小板计数)、凝血指标[D-二聚体(D-D)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB)]、肝肾功能[血尿素(BUN)、血肌酐(Scr)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、总蛋白(TP)]、血气指标[动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、动脉血氧饱和度(SaO2)]、心型脂肪酸结合蛋白(H-FABP)、肌钙蛋白I(cTnI)、N末端B型脑钠肽前体(NT-proBNP)、肺动脉收缩压(PASP)、急性生理学及慢性健康状况评估系统Ⅱ(APACHE Ⅱ)评分,并统计入院28d病死情况、治疗期间不良反应.结果 治疗后,2 组红细胞、血红蛋白、红细胞比容、血小板计数、D-D、FIB、PaCO2、H-FABP、cTnI、NT-proBNP、PASP、APACHE Ⅱ低于治疗前,且观察组低于对照组;2 组PT、APTT、PaO2、SaO2 高于治疗前,且观察组高于对照组(P<0.05,P<0.01).治疗前后,2 组组间和组内BUN、Scr、AST、ALT、TP 比较无明显差异(P>0.05).观察组入院 28d 病死率和治疗期间不良反应发生率(7.02％,8/114;7.89％,9/114)与对照组(10.53％,12/114;5.26％,6/114)比较无明显差异(P>0.05).结论 参芎葡萄糖可改善COPD合并PHD患者血常规、凝血指标及血气指标,并降低H-FABP、cTnI、NT-proBNP水平,进而减轻心肌损伤程度,缓解患者病情.
Abstract
Objective To investigate the clinical effect of combined therapy with Shenqiong glucose on chronic ob-structive pulmonary disease(COPD)complicated with pulmonary heart disease(PHD).Methods A total of 228 patients with COPD complicated with PHD were selected from January 2022 to January 2024 and randomly divided into observation group(n=114)and control group(n=114)by random number table method.The observation group was given Shenqiong glucose combined with conventional treatment,and the control group was given conventional treatment.Blood routine(erythro-cyte,erythrohemoglobin,hematocrit,platelet count),coagulation indexes[D-dimer(D-D),prothrombin time(PT),activa-ted partial thromplastin time(APTT),fibrinogen(FIB)],liver and kidney function[blood urea nitrogen(BUN),serum creatinine(Scr),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total protein(TP)],blood gas inde-xes[arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),arterial oxygen satura-tion(SaO2)],heart-type fatty acid-binding protein(H-FABP),cardiac troponin I(cTnI),N-terminal pro-B-type natriuretic peptide precursor(NT-proBNP),pulmonary artery systolic pressure(PASP),Acute Physiology And Chronic Health Evalua-tion Ⅱ(APACHE Ⅱ)scores were compared between the two groups.Additionally,28-day mortality after admission and ad-verse reactions during treatment were recorded.Results After treatment,erythrocyte,hemoglobin,hematocrit,platelet count,D-D,FIB,PaCO2,H-FABP,cTnI,NT-proBNP,PASP,APACHE Ⅱ in the two groups were lower than those before treatment,and lower in the observation group than in the control group.PT,APTT,PaO2 and SaO2 in the two groups were higher than those before treatment,and higher in the observation group than in the control group(P<0.05,P<0.01).Be-fore and after treatment,there were no significant differences in BUN,Scr,AST,ALT and TP between and within the two groups(P>0.05).There was no significant difference in 28-day mortality rate and the incidence of adverse reactions during treatment between the observation group[7.02％,8/114;7.89％,9/114]and control group(10.53％,12/114;5.26％,6/114)(P>0.05).Conclusion Shenqiong glucose can improve blood routine,coagulation indexes and blood gas indexes in COPD patients with PHD,and reduce the levels of H-FABP,cTnI and NT-proBNP,so as to reduce the degree of myocardi-al injury and alleviate the disease of patients.
基金项目
衡水市科技计划(2018)(2018014027Z)
国家科技期刊平台
NSTL
万方数据