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预防性抗凝治疗是否可能具有抗炎作用并降低COVID-19住院患者的死亡率?

Prophylactic Anticoagulant Treatment Might Have an Anti-inflammatory Effect and Reduce Mortality Rates in Hospitalized COVID-19 Patients?

作者信息

Alkan Sevil, Şener Alper, Doğan Ebru, Yüksel Cihan, Yüksel Buse

机构信息

Infectious Disease Department, Faculty of Medicine, Çanakkale Onsekiz Mart University, Canakkale, Turkey.

Public Health Department, Faculty of Medicine, Çanakkale Onsekiz Mart University, Canakkale, Turkey.

出版信息

Oman Med J. 2022 Jul 31;37(4):e394. doi: 10.5001/omj.2022.77. eCollection 2022 Jul.

Abstract

OBJECTIVES

COVID-19 associated coagulopathy and prophylactic anticoagulant therapy (PAT) are ongoing topics globally. Using PAT for anti-inflammatory effect may prevent thromboembolic events (TEEs). The objective of this study was to determine the anti-inflammatory effects of PAT in hospitalized COVID-19 patients.

METHODS

We conducted a retrospective observational study in a tertiary pandemic hospital. Patients were divided into two categories according to their PAT therapy status (PAT (+) and PAT (-)) and into three categories according to clinical features (mild: group 1; moderate: group: 2; and severe: group 3). We then evaluated laboratory parameters and clinical courses.

RESULTS

We included 662 hospitalized COVID-19 patients in this study. Enoxaparin sodium was given to all patients as PAT therapy. TEE was developed in five patients in the PAT (+) group. Pulmonary embolism developed in 3/5 patients and deep venous thrombosis in 2/5 patients. Disseminated intravascular coagulation (DIC) was detected in 54 patients in group 3. No statistically significant difference was found in 28-day mortality, development of DIC rates, intubation rates, and TEEs.

CONCLUSIONS

The use of PAT in critically ill patients was not effective in reducing C-reactive protein, which is one of the biomarkers of inflammation.

摘要

目的

新型冠状病毒肺炎(COVID-19)相关凝血病和预防性抗凝治疗(PAT)是全球范围内持续研究的课题。使用PAT以发挥抗炎作用可能预防血栓栓塞事件(TEE)。本研究的目的是确定PAT在住院COVID-19患者中的抗炎作用。

方法

我们在一家三级传染病医院进行了一项回顾性观察研究。根据患者的PAT治疗状态(PAT(+)和PAT(-))将患者分为两类,并根据临床特征分为三类(轻度:第1组;中度:第2组;重度:第3组)。然后我们评估了实验室参数和临床病程。

结果

本研究纳入了662例住院COVID-19患者。所有患者均接受依诺肝素钠作为PAT治疗。PAT(+)组有5例患者发生TEE。其中3/5患者发生肺栓塞,2/5患者发生深静脉血栓形成。第3组有54例患者检测到弥散性血管内凝血(DIC)。在28天死亡率、DIC发生率、插管率和TEE方面未发现统计学上的显著差异。

结论

在危重症患者中使用PAT对降低作为炎症生物标志物之一的C反应蛋白无效。

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