1.武汉大学人民医院重症医学科 湖北 武汉 430060
2.浙江大学医学院附属第二医院重症医学科/浙江省急危重症临床医学研究中心 浙江 杭州 310009
3.复旦大学附属中山医院急诊科/复旦大学应急救援与急危重症研究所 上海 200032
彭卫,男,1999—,医学硕士生,主要从事ARDS、脓毒症血管内皮功能保护的研究,E⁃mail:pengwei85@qq.com
李光,男,1982—,医学博士,主任医师,硕士生导师,主要从事ARDS、脓毒症及精准肺切片的研究,E⁃mail:9620594@qq.com
收稿:2024-07-11,
纸质出版:2025-02-25
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彭卫,柳舟,侯彦广等.舒洛地特注射液与低分子肝素在急性呼吸窘迫综合征患者中的应用效果比较[J].武汉大学学报(医学版),2025,46(02):181-186.
PENG Wei,LIU Zhou,HOU Yanguang,et al.Comparison of the efficacy of sulodexide injection and low molecular weight heparin in acute respiratory distress syndrome patients[J].Medical Journal of Wuhan University,2025,46(02):181-186.
彭卫,柳舟,侯彦广等.舒洛地特注射液与低分子肝素在急性呼吸窘迫综合征患者中的应用效果比较[J].武汉大学学报(医学版),2025,46(02):181-186. DOI: 10.14188/j.1671-8852.2024.0528.
PENG Wei,LIU Zhou,HOU Yanguang,et al.Comparison of the efficacy of sulodexide injection and low molecular weight heparin in acute respiratory distress syndrome patients[J].Medical Journal of Wuhan University,2025,46(02):181-186. DOI: 10.14188/j.1671-8852.2024.0528.
目的
2
比较舒洛地特(SDX)注射液和低分子肝素(LMWH)应用在急性呼吸窘迫综合征(ARDS)患者中的安全性及疗效。
方法
2
纳入2020年4月—2024年4月于武汉大学人民医院重症医学科住院的ARDS患者共40例,根据实际用药分为舒洛地特(SDX)组(20例)和低分子肝素(LMWH)组(20例)。采用独立样本
t
检验、Mann⁃Whitney
U
检验及卡方检验等统计学方法比较两组患者在一般资料、总住院时间、ICU住院时间、机械通气时间、血常规、凝血功能、肝功能指标及血气结果上的差异。
结果
2
两组患者一般情况、总住院时间及ICU住院时间的比较差异无统计学意义(
P
>
0.05)。与LMWH组相比,SDX组患者的机械通气时间减少(
P
<
0.05)。两组患者在用药后活化部分凝血活酶时间(APTT)均有延长,LMWH组患者治疗后纤维蛋白原(FIB)降低,SDX组患者治疗后白蛋白升高,两组患者给药后均出现红细胞计数(RBC)降低、血红蛋白(Hb)减少以及动脉血氧饱和度(SaO
2
)降低(
P
<
0.05)。两组患者给药前后丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、血小板计数(PLT)、D⁃二聚体对比差异均无统计学意义(
P
>
0.05)。
结论
2
相较于使用低分子肝素,ARDS患者使用舒洛地特注射液能够降低机械通气时间,且不会引起肝功能损伤、血小板降低等不良反应。
Objective
2
To compare the safety and efficacy of sulodexide (SDX) versus low molecular weight heparin (LMWH) in patients with acute respiratory distress syndrome (ARDS) through a retrospective study.
Methods
2
A retrospective cohort study included 40 ARDS patients hospitalized in the Department of Critical Care Medicine at Renmin Hospital of Wuhan University from April 2020 to April 2024. According to the actual medication
patients were divided into two groups: the SDX group (20 cases) and the LMWH group (20 cases). General conditions
total length of hospital stay
length of ICU stay
mechanical ventilation time
as well as blood routine
coagulation function
liver function
and blood gas results were compared between the SDX group and the LMWH group.
Results
2
There was no statistically significant difference in the general conditions
total hospitalization time
and ICU stay between the two groups (
P
>
0.05). Compared with those in the LMWH group
the mechanical ventilation time of patients in the SDX group was reduced (
P
<
0.05). Activated partial thromboplastin time (APTT) was prolonged in both groups after drug administration
fibrinogen (FIB) was decreased in patients in the LMWH group
and albumin was increased in patients in the SDX group after treatment. A decrease in red blood cell count (RBC)
a reduction in hemoglobin (Hb)
and a decrease in blood oxygen
saturation (SaO
2
) were observed in both groups after drug administration (
P
<
0.05). No statistically significant changes were found in alanine aminotransferase (ALT)
aspartate aminotransferase (AST)
platelet count (PLT)
and D⁃dimer after drug administration in both groups (
P
>
0.05).
Conclusion
2
Compared with the low molecular weight heparin
sulodexide injection in patients with ARDS reduces the duration of mechanical ventilation and does not cause adverse effects such as hepatic impairment and platelet reduction.
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