【摘要】：背景：重癥急性胰腺炎是臨床上較為常見的急腹癥之一，是一種累及多個器官的全身性疾病，其發(fā)病快，進展迅速，治療棘手，對其治療干預(yù)措施也處于不斷探索之中。重癥急性胰腺炎發(fā)病機制的復(fù)雜性決定其治療方式的復(fù)雜及多樣性。低分子量肝素的抗凝作用顯著，且副作用小，，目前被廣泛應(yīng)用于臨床中。研究發(fā)現(xiàn)，低分子量肝素除了抗凝血、抑制血小板聚集等作用外，還具有改變血流變性、抗炎、調(diào)節(jié)細胞凋亡、調(diào)節(jié)脂質(zhì)代謝等作用，可以通過干預(yù)重癥急性胰腺炎發(fā)病病理生理過程產(chǎn)生治療作用。 目的：通過綜述目前低分子量肝素治療重癥急性胰腺炎藥理機制及臨床療效研究進展，為以后更進一步研究提供參考。 方式：以“低分子量肝素，胰腺炎，重癥急性胰腺炎”等關(guān)鍵詞進行檢索，對低分子量肝素治療重癥急性胰腺炎研究方面文獻進行檢索。 結(jié)果：目前有大量關(guān)于低分子量肝素治療重癥急性胰腺炎方面研究，研究表明，低分子量肝素可能通過改善胰腺微循環(huán)、調(diào)節(jié)炎癥反應(yīng)、調(diào)節(jié)腺泡細胞凋亡、調(diào)節(jié)脂質(zhì)代謝等途徑在重癥急性胰腺炎病情進展中發(fā)揮作用。重癥急性胰腺綜合治療聯(lián)合使用低分子量肝素可能改善患者的預(yù)后、降低并發(fā)癥發(fā)生率及死亡率，而并不增加出血風(fēng)險。
[Abstract]:Background: severe acute pancreatitis (SAP) is one of the most common acute abdomen diseases. It is a systemic disease involving multiple organs. The complexity of the pathogenesis of severe acute pancreatitis determines the complexity and diversity of its treatment. Low-molecular weight heparin (LMWH) is widely used in clinic because of its remarkable anticoagulant effect and low side effect. In addition to anticoagulant and platelet aggregation inhibition, low molecular weight heparin (LMWH) also has the effects of changing blood rheology, anti-inflammation, regulating cell apoptosis, regulating lipid metabolism, etc. Intervention in the pathophysiological process of severe acute pancreatitis may have therapeutic effects. Objective: to review the pharmacological mechanism and clinical efficacy of low molecular weight heparin (LMWH) in the treatment of severe acute pancreatitis (SAP). Methods: the key words "low molecular weight heparin, pancreatitis and severe acute pancreatitis" were used to search the literature on the treatment of severe acute pancreatitis with low molecular weight heparin. Results: there has been a lot of research on the treatment of severe acute pancreatitis with low molecular weight heparin. The research shows that low molecular weight heparin may regulate the apoptosis of acinar cells by improving pancreatic microcirculation, regulating inflammatory reaction and regulating acinar cell apoptosis. Regulation of lipid metabolism plays an important role in the progression of severe acute pancreatitis. Combined use of low molecular weight heparin for severe acute pancreas therapy may improve the prognosis, reduce the incidence of complications and mortality, but do not increase the risk of bleeding.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R657.51

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