Low Molecular Weight Heparin in Treating Patients with Acute Exacerbation of COPD: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 YUANLi ¹ , FENGJing ² ,  LUOFeng-ming ¹

1. Department of Family Medicine, West China Hospital, Sichuan University, Chengdu 610041, China;
2. Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

LUOFeng-ming, Email: luofengming@hotmail.com

Keywords：

Low molecular weight heparin; Acute exacerbation of chronic obstructive pulmonary disease; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20140137

Video：

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Objective To systematically review the clinical efficacy of low molecular weight heparin (LMWH) in treating patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods Databases including PubMed, The Cochrane Library (Issue 10, 2013), EMbase, CBM, CNKI, VIP and WanFang Data were searched for the randomized controlled trials (RCTs) about LMWH in treating acute exacerbation of COPD from the establishment to October 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of the included studies. Meta-analysis was then performed using RevMan 5.2 software. Results A total of 6 RCTs involving 501 patients were finally included. The results of meta-analysis showed that:compared with the control group, LMWH significantly improved levels of D-dimmer (MD=-0.28, 95%CI-0.50 to-0.05, P=0.02), reduced carbon dioxide partial pressure (PaCO₂) (MD=-3.42, 95%CI-6.66 to-0.18, P=0.04), improved coagulation (PT) (MD=1.85, 95%CI 1.29 to 2.42, P < 0.000 01), and improved clinical symptoms and signs (RR=1.33, 95%CI 1.12 to 1.58, P=0.001), but it did not improve oxygen partial pressure (PaO₂) (MD=0.28, 95%CI-3.04 to 3.61, P=0.87). During treatment, no severe adverse reaction occurred in both groups. Conclusion LMWH could significantly improve symptoms caused by acute exacerbation of COPD. Due to limited quantity and quality of the included studies, the above conclusion needs to be confirmed by conducting more high quality RCTs with larger sample size.

Citation： YUANLi, FENGJing, LUOFeng-ming. Low Molecular Weight Heparin in Treating Patients with Acute Exacerbation of COPD: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2014, 14(7): 821-826. doi: 10.7507/1672-2531.20140137 Copy

1.	王小虎, 刘晓菊.莫西沙星与左氧氟沙星治疗慢性阻塞性肺疾病急性加重期疗效及安全性比较的系统评价.中国循证医学杂志, 2012, 12(6):694-699.
2.	冯玉麟, 王岚.中国COPD防治的难题.中国呼吸与危重监护杂志, 2012, 11(4):313-316.
3.	葛琴.慢性阻塞性肺病急性加重期高凝状态检测的意义.临床肺科杂志, 2011, 16(10):1560-1561.
4.	王艳青, 孙妮娜, 程兆忠, 等. COPD大鼠血栓前状态不同阶段低分子肝素抗凝观察.青岛大学医学院学报, 2013, 49(3):243-248.
5.	韩振军. COPD的血栓前状态和抗凝治疗.临床肺科杂志, 2009, 14(4):503-506.
6.	Higgins JPT, Green S. Cochrane Handbook for Systematic Reviewers of Interventions[cited 2011 March]. Available at:http://www.cochrane-handbook.org.
7.	宋庆军, 陈如华.低分子肝素抗凝在治疗慢性阻塞性肺病急性加重期疗效分析.社区医学杂志, 2009, 7(3):74-75.
8.	Qian YB, Xie H, Tian R, et al. Efficacy of low molecular weight heparin in patients with acute exacerbation of chronic obstructive pulmonary disease receiving ventilatory support. COPD, 2013, 10(1541-2555):1-6.
9.	张春美.慢性阻塞性肺病急性加重期抗凝治疗的临床观察.现代预防医学, 2012, 39(22):6075-6081.
10.	王刚.低分子肝素治疗慢性阻塞性肺病急性加重期42例疗效观察.当代医学, 2010, 16 (24):21-84.
11.	胡伟贞, 王锡英.低分子肝素在慢性阻塞性肺疾病急性加重期治疗中的疗效探讨.海峡药学, 2011, 23(5):76-78.
12.	陈卫民, 戚应静, 李宇峰, 等.低分子肝素治疗慢性阻塞性肺疾病急性加重期的临床观察.临床合理用药, 2010, 3(15):4-5.
13.	马春兰, 陈红, 梁斌苗, 等. N-乙酰半胱氨酸对慢性阻塞性肺疾病稳定期作用的Meta分析.中国循证医学杂志, 2011, 11(10):1156-1160.
14.	王应强, 杨宗霞, 李幼平, 等.我国示范乡镇卫生院基本药物循证评价与遴选之七:慢性阻塞性肺疾病.中国循证医学杂志, 2012, 12(8):907-922.
15.	张瑞.盐酸氨溴索雾化对COPD患者氧化应激的影响.临床肺科杂志, 2013, 18(5):894-895.
16.	陆再英, 主编.内科学.第7版.北京:人民卫生出版社, 2007:62-63.
17.	胡守玉.藻酸双酯钠对AECOPD血液高凝状态的影响.基层医学论坛, 2012, 12(16):4646-4647.
18.	高光敏, 强丽霞, 王凤爽, 等.低分子量肝素对慢性阻塞性肺疾病大鼠的肺功能及气道炎性细胞的影响.现代生物医学进展, 2012, 12(36):705-710.
19.	吕春儿.低分子肝素抗凝治疗慢性阻塞性肺疾病急性加重期的机制与疗效.中国现代医生, 2013, 51(18):45-47.
20.	李丹丹, 孟建中, 焦炳华.低分子肝素的新作用-抗炎/抗细胞粘附机制的研究进展.生物医学工程研究, 2008, 27(2):133-136.

1. 王小虎, 刘晓菊.莫西沙星与左氧氟沙星治疗慢性阻塞性肺疾病急性加重期疗效及安全性比较的系统评价.中国循证医学杂志, 2012, 12(6):694-699.
2. 冯玉麟, 王岚.中国COPD防治的难题.中国呼吸与危重监护杂志, 2012, 11(4):313-316.
3. 葛琴.慢性阻塞性肺病急性加重期高凝状态检测的意义.临床肺科杂志, 2011, 16(10):1560-1561.
4. 王艳青, 孙妮娜, 程兆忠, 等. COPD大鼠血栓前状态不同阶段低分子肝素抗凝观察.青岛大学医学院学报, 2013, 49(3):243-248.
5. 韩振军. COPD的血栓前状态和抗凝治疗.临床肺科杂志, 2009, 14(4):503-506.
6. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviewers of Interventions[cited 2011 March]. Available at:http://www.cochrane-handbook.org.
7. 宋庆军, 陈如华.低分子肝素抗凝在治疗慢性阻塞性肺病急性加重期疗效分析.社区医学杂志, 2009, 7(3):74-75.
8. Qian YB, Xie H, Tian R, et al. Efficacy of low molecular weight heparin in patients with acute exacerbation of chronic obstructive pulmonary disease receiving ventilatory support. COPD, 2013, 10(1541-2555):1-6.
9. 张春美.慢性阻塞性肺病急性加重期抗凝治疗的临床观察.现代预防医学, 2012, 39(22):6075-6081.
10. 王刚.低分子肝素治疗慢性阻塞性肺病急性加重期42例疗效观察.当代医学, 2010, 16 (24):21-84.
11. 胡伟贞, 王锡英.低分子肝素在慢性阻塞性肺疾病急性加重期治疗中的疗效探讨.海峡药学, 2011, 23(5):76-78.
12. 陈卫民, 戚应静, 李宇峰, 等.低分子肝素治疗慢性阻塞性肺疾病急性加重期的临床观察.临床合理用药, 2010, 3(15):4-5.
13. 马春兰, 陈红, 梁斌苗, 等. N-乙酰半胱氨酸对慢性阻塞性肺疾病稳定期作用的Meta分析.中国循证医学杂志, 2011, 11(10):1156-1160.
14. 王应强, 杨宗霞, 李幼平, 等.我国示范乡镇卫生院基本药物循证评价与遴选之七:慢性阻塞性肺疾病.中国循证医学杂志, 2012, 12(8):907-922.
15. 张瑞.盐酸氨溴索雾化对COPD患者氧化应激的影响.临床肺科杂志, 2013, 18(5):894-895.
16. 陆再英, 主编.内科学.第7版.北京:人民卫生出版社, 2007:62-63.
17. 胡守玉.藻酸双酯钠对AECOPD血液高凝状态的影响.基层医学论坛, 2012, 12(16):4646-4647.
18. 高光敏, 强丽霞, 王凤爽, 等.低分子量肝素对慢性阻塞性肺疾病大鼠的肺功能及气道炎性细胞的影响.现代生物医学进展, 2012, 12(36):705-710.
19. 吕春儿.低分子肝素抗凝治疗慢性阻塞性肺疾病急性加重期的机制与疗效.中国现代医生, 2013, 51(18):45-47.
20. 李丹丹, 孟建中, 焦炳华.低分子肝素的新作用-抗炎/抗细胞粘附机制的研究进展.生物医学工程研究, 2008, 27(2):133-136.

Chinese Journal of Evidence-Based Medicine

Low Molecular Weight Heparin in Treating Patients with Acute Exacerbation of COPD: A Meta-Analysis

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