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| 低分子肝素辅助治疗 D-二聚体升高的新生儿继发性肺动脉高压的疗效 |
| 陈波,李广洪,白波,罗惠玲,黄学良,张燕钦,黄惠仪,李菲 |
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| (南方医科大学附属花都医院,广州市花都区人民医院,广州 510800) |
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| 摘要: |
| 目的:探讨低分子肝素(LMWP)辅助治疗 D-二聚体升高的新生儿继发性肺动脉高压(PH)的疗效。 方法:选取 2020 年6 月至 2023 年 5 月南方医科大学附属花都医院新生儿重症监护室收治的 100 例血浆 D-二聚体>1 000 ng / mL 的继发性 PH 新生儿。 基于不同氧疗方式分为经鼻持续气道正压通气(NCPAP)组和有创机械通气( IMV) 组各 50 例,两组患儿根据是否加用LMWP 治疗,按入组顺序再分为观察组 A、观察组 B、对照组 A、对照组 B 亚组各 25 例。 比较分析各组患儿 72 小时内肺动脉收缩压(PASP)、血浆 D-二聚体水平及不良反应发生情况。 结果:各组患儿胎龄、日龄、基础疾病等基线资料比较差异均无统计学意义(P>0. 05)。 观察组 A、B 治疗后 D-二聚体中位数水平均较其相对应的对照组 A、B 及治疗前明显降低(P 均<0. 05),对照组 A、B 的 D-二聚体中位数水平比较差异无统计学意义(P 均>0. 05)。 观察组 A、B 治疗总有效率分别为 88%、84%,高于其相对应的对照组 A、B(P 均<0. 05)。 结论:高凝状态或血栓形成引起的血管内梗阻可能是新生儿继发性 PH 的重要原因,加用LMWP 辅助治疗可提高疗效。 |
| 关键词: 低分子肝素 肺动脉高压 D-二聚体 新生儿 安全性 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2024.06.009 |
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| 基金项目:广州市科技计划项目,编号 202102080666 |
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| 南方医科大学附属花都医院,广州市花都区人民医院,广州 510800 |
| Chen Bo, Li Guanghong, Bai Bo, Luo Huiling, Huang Xueliang, Zhang Yanqin, Huang Huiyi, Li Fei |
| (HuaduHospital Affiliated to Southern Medical University, Guangzhou Huadu District People’s Hospital, Guangzhou 510800, China) |
| Abstract: |
| Objective: To probe into the efficacy of low molecular weight heparin ( LMWP) in the adjuvant treatment of secondarypulmonary hypertension (PH) in neonates with elevated D-dimer. Methods: From Jun. 2020 to May 2023, a total of 100 neonates withsecondary PH and plasma D-dimer >1,000 ng / mL hospitalized in neonatal intensive care unit of Huadu Hospital Affiliated to SouthernMedical University were extracted to be divided into nasal continuous airway positive pressure (NCPAP) group and invasive mechanicalventilation (IMV) group based on different oxygen therapy methods, with 50 cases in each group. Both groups were divided into theobservation group A and B, and control group A and B subgroups according to whether or not receiving LMWP therapy, with 25 cases in each group. Pulmonary artery systolic blood pressure (PASP), D-dimer level and occurrence of adverse drug reactions in each groupwere compared and analyzed within 72 h. Results: There were no significant differences in gestational age, age, and underlying diseasesamong all groups (P>0. 05). The median level of D-dimer in observation group A and B after treatment were significantly lower thanthose in corresponding control group A and B and before treatment (P<0. 05). The median level of D-dimer in control group A and Bwere lower than those before treatment, yet there was no statistically significant difference ( P > 0. 05). The total effective rate ofobservation group A and B was respectively 88% and 84%, higher than that of corresponding control group A and B ( P < 0. 05).Conclusion: Intravascular obstruction induced by hypercoagulability or thrombosis may be an important cause of neonatal secondary PH,and the adjuvant treatment with LMWP can improve the curative effect |
| Key words: low molecular weight heparin pulmonary hypertension D-dimer neonate safety |
