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

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