萧志勇　梁兴　俞灿

【摘要】 目的：研究低分子肝素輔助治疗高脂血症性重症急性胰腺炎的效果及对患者凝血功指标的影响。方法：选取笔者所在医院2018年2月-2019年3月收治的61例高脂血症性重症急性胰腺炎患者为研究对象。按随机数字表法将患者分为试验组（30例）和对照组（31例），给予对照组患者常规治疗，试验组患者在对照组患者治疗的基础上给予低分子肝素辅助治疗。治疗2周后比较两组患者临床疗效、甘油三酯、淀粉酶、总胆汁酸水平及凝血功能情况。结果：治疗后试验组患者临床总有效率为90.00%，显著高于对照组的67.74%，差异有统计学意义（P<0.05）;观察组甘油三酯、淀粉酶和总胆汁酸均低于对照组，差异均有统计学意义（P<0.05），试验组患者凝血功能指标凝血酶时间（TT）、凝血酶原时间（PT）显著短于对照组，D-二聚体（D-D）、纤维蛋白原（FIB）显著低于对照组，差异均有统计学意义（P<0.05）。结论：低分子肝素辅助治疗高脂血症性重症急性胰腺炎的临床效果理想，能有效改善患者甘油三酯、淀粉酶、总胆汁酸和凝血功能水平。

【关键词】 低分子肝素 高脂血症 重症急性胰腺炎 凝血功能

doi：10.14033/j.cnki.cfmr.2020.16.019 文献标识码 B 文章编号 1674-6805（2020）16-00-03

The Effect of Low Molecular Weight Heparin in the Treatment of Hyperlipidemic Severe Acute Pancreatitis/XIAO Zhiyong， LIANG Xing， YU Can. //Chinese and Foreign Medical Research， 2020， 18（16）： -50

[Abstract] Objective： To study the effect of Low Molecular Weight Heparin （LMWH） in the treatment of hyperlipidemic severe acute pancreatitis （SAP） and its influence on coagulation function. Method： A total of 61 patients with severe hyperlipidemic acute pancreatitis admitted to our hospital from February 2018 to March 2019 were selected as the study objects. According to the method of random number table， the patients were divided into the experimental group （30 cases） and the control group （31 cases）. The patients in the experimental group were given routine treatment， and the patients in the experimental group were given Low Molecular Weight Heparin auxiliary treatment on the basis of the patients in the control group. Two weeks after treatment， the clinical effect， triglyceride， amylase， total bile acid and coagulation function of the two groups were compared. Result： After treatment， the total clinical effective rate of the experimental group was 90.00%， which was significantly higher than 67.74% of the control group， the difference was statistically significant （P<0.05）. The triglyceride， amylase and total bile acid were all lower than those of the control group， the differences were statistically significant （P<0.05）. The coagulation function indexes such as thrombin time （TT）， prothrombin time （PT） of the experimental group were significantly shorter than those of the control group， the D-Dimer （D-D）， fibrinogen （FIB） of the experimental group were significantly lower than those of the control group， the differences were statistically significant （P<0.05）. Conclusion： Low Molecular Weight Heparin can effectively improve the levels of triglyceride， amylase， total bile acid and coagulation in patients with severe acute hyperlipidemic acute pancreatitis.

[Key words] Low Molecular Weight Heparin Hyperlipidemia Severe acute pancreatitis Coagulation function

First-authors address： Xinyi Peoples Hospital， Xinyi 525300， China

高脂血症导致的高甘油三酯血症已成为我国诱发重症急性胰腺炎的第二大诱因，甘油三酯异常升高不仅是重症胰腺炎的病因还是加重重症胰腺炎的重要条件。因此临床上应将迅速降低患者甘油三酯作为主要治疗原则之一，而目前临床上治疗多以抑酸、禁食、减压、灌肠等治疗为主，缺乏对患者甘油三酯水平控制的治疗。低分子肝素为常规抗凝药物，近年来，现代药理学证明其不仅具有抗凝作用还具有调节脂质代谢的作用，已有国外学者将其作为降脂药物应用于临床，但在我国尚缺乏相关研究报道[1]。故笔者选用低分子肝素与常规治疗相结合应用于高脂血症性重症急性胰腺炎中分析其對患者甘油三酯的影响，现报道如下。……