丹参注射液联合低分子肝素改善乳腺癌手术后血管内皮细胞功能和血流变异常的临床研究

摘要

目的 观察丹参注射液联合低分子肝素对乳腺癌手术后血管内皮细胞功能和血流变的改善情况.方法 将100例乳腺癌手术患者随机分为两组,其中丹参联合低分子肝素组(观察组)50例静脉给予丹参注射液,并皮下注射低分子肝素钠；低分子肝素组(对照组)50例,只皮下注射低分子肝素钠,于第1天和14天观察两组临床疗效及临床积分、血管内皮功能指标、血浆TXA2和PGI2水平和血流变参数变化.结果 观察组总有效率94％,时照组总有效率86％,两组间差异有统计学意义(x2=8.104,P＜0.05)；观察组临床积分优于对照组,差异有统计学意义(P＜0.01).观察组ET-I水平、tPA水平、TXA2和PGI2水平均较对照组低,差异有统计学意义(均P＜0.05)；观察组血流变参数红细胞比容％(HCT％)、血浆粘度比(mPa.s)、红细胞电泳时间(s)和纤维蛋白原(g/L)改善情况优于对照组,差异有统计学意义(均P＜0.05).两组患者治疗中均未出现严重不良反应.结论 丹参联合低分子肝素可明显改善乳腺癌术后患者血管内皮细胞功能和血流变异常状态,能有效预防下肢深静脉血栓的影成和肺栓塞的发生.%Objective To investigate the effect of salviae miltiorrhiza combined with low molecular heparin sodium on endothelial function and hemorheological parameters in patients after breast cancer surgery.Methods 100 patients after breast cancer surgery were randomly divided into 2 group,salviae miltiorrhiza combined with low molecular heparin sodium treatment group (treatment group) and low molecular heparin sodium treatment group (control group),with 50 patients in each.The curative effect,clinical integrals,endothelial indexes were evaluated.And the serum levels of TXA2 and PGI2 and hemorheological parameters were measured.Results The curative effect and clinical integrals were better in treatment group (P＜0.05 in all) on day 14.Meanwhile,ET-1,tPA,TXA2 and PGI2 were markedly lower in treatment group than in control group.Furthermore,hemorheological parameters,including hematocrit％ (HCT％),plasma viscosity (PV),erythrocyte electrophoretic time (EET) and fibrinogen (FN),were remarkably reduced in treatment group,compared with control group.Conclusion Salviae miltiorrhiza combined with low molecular heparin sodium can effectively improve endothelial dysfunctions and hemorheological parameters.Meanwhile,deep venous thrombosis (DVT) and pulmonary thromboembolism (PTE) in patients with breast cancer surgery were significantly reduced after salviae miltiorrhiza combined with low molecular heparin sodium treatment.