Anticoagulation therapy in patients with chronic obstructive pulmonary disease in the acute exacerbation stage

Shi,Xiaoshan; Li,Hongyun

doi:10.3892/etm.2013.1001

Anticoagulation therapy in patients with chronic obstructive pulmonary disease in the acute exacerbation stage

Authors:
- Xiaoshan Shi
- Hongyun Li
View Affiliations

Affiliations: Department of Respiratory Medicine, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
Published online on: March 12, 2013 https://doi.org/10.3892/etm.2013.1001
Pages: 1367-1370

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

This aim of this study was to investigate the effects of intervention with low-molecular-weight heparin calcium on the pulmonary function and blood coagulation function of patients with chronic obstructive pulmonary disease (COPD) in the acute exacerbation stage. A total of 70 patients with COPD in the acute exacerbation stage were selected and randomly divided into the control group (32 cases) and the anticoagulation group (38 cases). The patients of the control group were treated with oxygen therapy, spasmolysis, asthmarelief, cough relief and sputum reduction. The patients in the anticoagulation group, in addition to the conventional therapy used the control group, were also treated with low‑molecular‑weight heparin calcium 4100 AXaIU/time. by abdominal subcutaneous injection once every 12 h. For both groups, one treatment course lasted 10 days. The pulmonary function indicators and blood coagulation indicators of the two groups before and after treatment were determined. Following treatment, the pulmonary function and arterial blood gas indicators of the two groups were significantly better than those before treatment, and the extents of the improvements in the anticoagulation group were significantly greater than those in the control group. The D-dimer level and blood coagulation indicators [international normalized ratio (INR), prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) concentration] of the anticoagulation group were significantly improved compared with those prior to treatment, but there were no significant differences between these measures before and after treatment for patients in the control group. No serious adverse reaction occurred in the anticoagulation group. Although, the conventional therapy was able to improve the overall condition of patients with COPD, it was not able to effectively improve the hypercoagulative state of the patients' blood. The combination of conventional therapy with low-molecular-weight heparin calcium anticoagulation improved the blood coagulation and pulmonary functions of patients.

View Figures

View References

1.	Hu XY, Li Y, Du YC and Xu JY: Prethrombolic state and efficacy of anticoagulation of patients with acute exacerbations of chronic obstructive pulmonary disease. International Journal of Respiration. 29:519–522. 2009.(In Chinese).
2.	Jiang ZH, Lv YW, Sang HY, Zhu MY, Zhu ZP and Ding P: The study of prethrombotic state in patients with chronic respiratory failure study. Chinese Journal of Emergency Medicine. 16:75–77. 2007.(In Chinese).
3.	Huang J, Liu XJ and Bao HR: Chronic obstructive pulmonary disease in patients with coagulation dysfunction and oxidative stress in the relationship between. J Int Med. 50:82011.(In Chinese).
4.	Huang J, Liu XJ, Bao HR, Zhang Y, Tan EL and Liao JM: The relationship between coagulation/anticoagulation imbalance and oxidative stress in patients with chronic obstructive pulmonary disease. Zhonghua Nei Ke Za Zhi. 50:664–667. 2011.(In Chinese).
5.	Wang PF and Ling CH: Correlation study of patients with chronic obstructive pulmonary disease (COPD) arterial blood gas analysis and plasma D-dimer. Hemorheol. 20:87–88. 2010.(In Chinese).
6.	Chronic Obstructive Pulmonary Disease Committee, Respiratory Society, Chinese Medical Association: Improved confidence, right awareness and rational treatment: opening up a new era of prevention and treatment of chronic obstructive pulmonary disease. Zhonghua Jie He He Hu Xi Za Zhi. 30:3–5. 2007.(In Chinese).
7.	Zarfis JH: Atherosclerosis thrombosis and inflammatory risk factors from history and the laboratory to real life. Eur Heart J. 26:317–318. 2005. View Article : Google Scholar : PubMed/NCBI
8.	Ye XF, Liu S and Yang JH: Pulmonary heart disease in patients with D-dimer levels and systolic pulmonary artery pressure and carbon dioxide partial pressure correlation analysis. Cardiopulmonary Vascular J. 27:89–91. 2008.(In Chinese).
9.	Yu CN, Sun L and Jiang P: Patients with pulmonary heart disease coagulation and fibrinolysis state. Zhonghua Jian Yan Yi Xue Za Zhi. 4:320–321. 2008.(In Chinese).
10.	Duan JM, An X, Zhang JY, Xu F and Liu P: Chronic obstructive pulmonary disease (COPD) patients with hypoxemia clinical D-dimer testing and clinical analysis. Journal of Clinical Pulmonary Medicine. 13:199–200. 2008.(In Chinese).
11.	Wu WN, Wang LX and Chen SX: Patients with chronic obstructive pulmonary disease (COPD) erythrocyte sedimentation rate, hematocrit, D-dimer, pulmonary artery systolic pressure. Practical J Med. 25:19–20. 2009.(In Chinese).
12.	Dahl M, Tybjaerg-Hansen A, Vestbo J, Lange P and Nordestgaard BG: Elevated plasma fibrinogen associated with reduced pulmonary function and increased risk of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 164:1008–1011. 2001. View Article : Google Scholar : PubMed/NCBI
13.	Wu TP: Significance in patients with chronic obstructive pulmonary disease D-dimer. Chin Med. 2:50–51. 2007.(In Chinese).
14.	Yu QH and Li YC: Chronic obstructive pulmonary disease in patients with D-dimer and antithrombin relationship with prognosis. Tianjin Traditional Chin Med. 38:389–391. 2010.(In Chinese).
15.	Mo FP: Chronic obstructive pulmonary disease with acute exacerbation of plasma D-dimer changes and the impact on the lung function of Guangxi Medical University, Department of Respiratory Medicine, 2011 (In Chinese).
16.	Wu ZX, Zhang CF, Wang W, Li ZQ, Wang BF and Xu H: Therapeutic Effect of LMWH for Acute Exacerbation Patients of Pulmonary Heart Disease. China Health Industry. 8:5–6. 2011.(In Chinese).
17.	Zhang Y, Li YX, Cao Y, Chai YL and Niu XQ: Unfractionated heparin and low-molecular-weight heparin in AECOPD pulmonary embolism in clinical observation. Journal of Kunming Medical University. 6:82–84. 2012.(In Chinese).
18.	Segal JB, Streiff MB, Hofmann LV, Thornton K and Bass EB: Management of venous thromboembolism: a systematic review for a practice guideline. Ann Intern Med. 146:211–222. 2007. View Article : Google Scholar : PubMed/NCBI
19.	Chen LY, Ying KJ, Hong WJ and Zhou P: Comparison of low-molecular-weight-heparin and unfractionated heparin for acute PTE. J Zhejiang Univ Sci B. 6:1195–1199. 2005. View Article : Google Scholar : PubMed/NCBI
20.	Wang R and Peng HX: Low-molecular-weight heparin and heparin sodium efficacy for the treatment of pulmonary heart disease with comparison - report of 40 cases. New Med. 39:36–37. 48:2008.
21.	Qiu XY and Jin N: Anticoagulant treatment of severe chronic obstructive pulmonary disease oxygenation function and central venous pressure impact. Chin Modern Sci Magazine. 5:231–232. 2008.(In Chinese).