低分子肝素与尿激酶治疗不稳定性冠状动脉疾病对比观察

不稳定性冠状动脉疾病(unstable coronary disease,UCAD)包括不稳定性心绞痛和非Q波性心肌梗塞.文献报道,在常规抗心肌缺血、抗血小板治疗的基础上,低分子肝素(LMWH)对UC AD有较好的临床疗效,可缓解心绞痛和降低复合终点事件的发生率,尿激酶(UK)的溶栓效果存在争论.本研究采用单盲、随机、对照的方法,比较LMWH与小剂量UK对UCAD的临床疗效.     

低分子肝素治疗不稳定性心绞痛疗效观察

不稳定性心绞痛(UAP)是介于稳定性心校痛与急性心肌梗死(AMI)和猝死之间的一种中间临床状态。UAP患者病情严重,预后欠佳,因此,选择适当的治疗对改善其预后有重要临床意义。     

低分子肝素治疗非ST段抬高急性冠状动脉综合征的疗效

目的探讨低分子肝素对非ST段抬高急性冠状动脉综合征的疗效。方法52例非ST段抬高急性冠状动脉综合征患者在常规抗心肌缺血治疗基础上予以低分子肝素治疗。结果非ST段抬高急性冠状动脉综合征缓解率达92．3％,心电图改善率达80．8％,除4例局部注射处出现瘀斑外,余未见不良反应。结论低分子肝素对急性非ST段抬高冠状动脉综合征有较好的疗效和安全性。     

低分子肝素治疗不稳定型心绞痛疗效及安全性

目的　 观察低分子肝素在不稳定型心绞痛 (UAP)治疗中的效果和不良反应。 方法　1998年 2月～ 2 0 0 1年 10月间对 34例不稳定型心绞痛患者给予低分子肝素治疗。观察心绞痛发作次数 ,持续时间 ,常规心电图ST T改变及不良反应发生率。同时与常规治疗组 34例患者进行比较。 结果　低分子肝素对不稳定型心绞痛可快速阻止心绞痛发作 ,治疗期间无急性心肌梗塞 (AMI)及严重心律失常发生。疗效明显优于常规治疗组 ,常规治疗组发生AMI 4例 ,重度心律失常 6例 ,两组比较有差异 (P <0 0 5 )。两组血小板、凝血时间、凝血酶原时间均无显著影响。 结论　低分子肝素治疗不稳定型心绞痛安全有效。     

低分子肝素钠治疗不稳定性心绞痛疗效观察

２０００年～２００２年 ,我们对不稳定性心绞痛 (ＵＡＰ)患者应用低分子肝素钠治疗 ,取得较好近期疗效 ,现报道如下 :１对象和方法１ １对象 :根据１９７９年ＷＨＯ制定的缺血性心脏病命名和诊断标准 ,选择７０例符合标准的ＵＡＰ患者 ,随机分为二组 ,每组３５例 ,观察组 :男２０例 ,女１５例 ,年龄５０～７０岁 ,平均６２ ３岁 ,其中初发劳力性心绞痛１０例 ,恶化劳性心绞痛１５例 ,自发性心绞痛９例 ,梗死后心绞痛１例。对照组 :男２２例 ,女１３例 ,年龄５１～７３岁 ,平均６１ ８岁 ,其中初发劳力性心绞痛９例 ,恶化劳力性心绞痛１７例…     

低分子肝素钠治疗慢性阻塞性肺疾病合并呼吸衰竭的临床疗效

目的 探讨低分子肝素钠治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭的临床疗效.方法 选取南平市建阳第一医院2017年4月-2019年4月收治的COPD合并呼吸衰竭患者72例,按照治疗方式不同分为对照组与观察组,各36例.对照组予以常规治疗,观察组在对照组治疗基础上给予低分子肝素钠治疗.比较2组治疗前后肺功能指标〔包括第...     

低分子肝素治疗不稳定性心绞痛的疗效

不稳定性心绞痛(UAP)是介于稳定性劳力性心绞痛和急性心肌梗死(AMI)之间的一组进行性恶化的不同形式的心绞痛症候群.其临床及病变复杂,进展快,预后较严重.如不及时给予有效治疗,可发展为AMI,甚至猝死.近年来,低分子肝素在治疗不稳定性心绞痛中的地位日益提高,我科自1999-02～2003-12使用低分子肝素(LMWH,速避凝)治疗不稳定性心绞痛48例.现报告如下.     

低分子肝素钠治疗不稳定性心绞痛疗效观察

2000～2002年,我们对不稳定心绞痛(UAP)患者应用低分子肝素钠治疗,取得较好疗效,现报道如下.     

巴曲酶联合低分子肝素钠治疗进展性脑梗死的疗效观察

目的探讨巴曲酶联合低分子肝素钠治疗进展性脑梗死的效果。方法将起病在72h内的56例脑梗死患者随机分为巴曲酶联合低分子肝素钠治疗组(治疗组)和低分子肝素钠治疗组(对照组),治疗组在常规治疗的基础上加用巴曲酶,第1天10BU,第2、3天各5BU静脉滴注,同时用低分子肝素钠2500单位。2次/d腹部皮下注射,连续7d。对照组在常规治疗的基础上只加用低分子肝素钠。治疗前后检测凝血活酶时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、血浆纤维蛋白原,并对治疗前、治疗后4周神经功能缺损进行评分。结果治疗组1例而对照组7例发生进展性脑梗死,两组比较差异有统计学意义(P<0.05);治疗组治疗后血浆纤维蛋白原降低,TT、PT、APTT轻度延长,但均在正常范围内。结论巴曲酶联合分子肝素钠治疗能降低进展性脑梗死的发生率,有利于进展性脑梗死患者神经功能的恢复。     

巴曲酶联合低分子肝素钠治疗进展性脑梗死的疗效观察

目的 探讨巴曲酶联合低分子肝素钠治疗进展性脑梗死的效果.方法 将起病在72h内的56例脑梗死患者随机分为巴曲酶联合低分子肝素钠治疗组(治疗组)和低分子肝素钠治疗组(对照组),治疗组在常规治疗的基础上加用巴曲酶,第1天10BU,第2、3天各5BU静脉滴注,同时用低分子肝素钠2500单位.2次/d腹部皮下注射,连续7d.对照组在常规治疗的基础上只加用低分子肝素钠.治疗前后检测凝血活酶时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、血浆纤维蛋白原,并对治疗前、治疗后4周神经功能缺损进行评分.结果 治疗组1例而对照组7例发生进展性脑梗死,两组比较差异有统计学意义(P＜0.05);治疗组治疗后血浆纤维蛋白原降低,TT、PT、APTT轻度延长,但均在正常范围内.结论 巴曲酶联合分子肝素钠治疗能降低进展性脑梗死的发生率,有利于进展性脑梗死患者神经功能的恢复.     

Low molecular weight heparin in unstable coronary artery disease

Since the recognition that any thrombosis overlying a ruptured atherosclerotic plaque is a central component of the pathogenesis of unstable coronary artery disease (CAD), a number of antithrombotic treatment strategies have been investigated in randomised clinical trials. Aspirin reduces the occurrence of symptomatic and silent ischaemia, myocardial infarction (MI) and death in patients with unstable CAD, both in the acute phase and during continued long-term treatment and is now considered routine therapy. The addition of unfractionated heparin infusion further reduces cardiac events during the treatment period, but is not associated with any sustained benefits during long-term follow-up. Low molecular weight heparins (LMWHs) are completely absorbed by the sc. route. A predictable anticoagulant effect is maintained by sc. injections every 12 - 24 h without laboratory monitoring. The FRISC trial demonstrated that, in conjunction with aspirin, the LMWH dalteparin reduced death and MI by more than 50% in the acute phase. Four similar trials have directly compared LMWH with unfractionated heparin and demonstrated at least the same efficacy in the acute phase, treated between three and eight days. The LMWH enoxaparin was more effective at reducing death or MI than unfractionated heparin infusion during the three days of treatment, an effect which lasted up to 12 months. Prolonged out-patient treatment beyond the acute phase has been evaluated in four trials. It was demonstrated, in two of these trials, that continuing twice-daily injections of dalteparin further reduced the risk of death, MI and need for revascularisation at least during the initial six weeks of treatment. This effect was confined, however, to patients with signs of myocardial damage, i.e., elevation of troponin, at admission. During prolonged out-patient treatment, there is an increased risk of severe bleeding due to the combination of LMWH with aspirin. Based on successful results, the LMWHs, having the convenience of treatment and the option for continuation in an out-patient setting, should replace unfractionated heparin as the routine treatment in unstable CAD. If an early invasive procedure is considered, the LMWH therapy should be continued until the intervention as a 'bridge-to-revascularisation'. New antiplatelet agents are also emerging as additional useful tools for treating these patients, thus it is urgent to evaluate the comibination of these new therapies with the LMWHs.     

Low molecular weight heparin in unstable coronary artery disease

Since the recognition that any thrombosis overlying a ruptured atherosclerotic plaque is a central component of the pathogenesis of unstable coronary artery disease (CAD), a number of antithrombotic treatment strategies have been investigated in randomised clinical trials. Aspirin reduces the occurrence of symptomatic and silent ischaemia, myocardial infarction (MI) and death in patients with unstable CAD, both in the acute phase and during continued long-term treatment and is now considered routine therapy. The addition of unfractionated heparin infusion further reduces cardiac events during the treatment period, but is not associated with any sustained benefits during long-term follow-up. Low molecular weight heparins (LMWHs) are completely absorbed by the sc. route. A predictable anticoagulant effect is maintained by sc. injections every 12 - 24 h without laboratory monitoring. The FRISC trial demonstrated that, in conjunction with aspirin, the LMWH dalteparin reduced death and MI by more than 50% in the acute phase. Four similar trials have directly compared LMWH with unfractionated heparin and demonstrated at least the same efficacy in the acute phase, treated between three and eight days. The LMWH enoxaparin was more effective at reducing death or MI than unfractionated heparin infusion during the three days of treatment, an effect which lasted up to 12 months. Prolonged out-patient treatment beyond the acute phase has been evaluated in four trials. It was demonstrated, in two of these trials, that continuing twice-daily injections of dalteparin further reduced the risk of death, MI and need for revascularisation at least during the initial six weeks of treatment. This effect was confined, however, to patients with signs of myocardial damage, i.e., elevation of troponin, at admission. During prolonged out-patient treatment, there is an increased risk of severe bleeding due to the combination of LMWH with aspirin. Based on successful results, the LMWHs, having the convenience of treatment and the option for continuation in an out-patient setting, should replace unfractionated heparin as the routine treatment in unstable CAD. If an early invasive procedure is considered, the LMWH therapy should be continued until the intervention as a ‘bridge-to-revascularisation’. New antiplatelet agents are also emerging as additional useful tools for treating these patients, thus it is urgent to evaluate the comibination of these new therapies with the LMWHs.     

低相对分子质量肝素钠用于血液透析抗凝的疗效和安全性

目的：观察低相对分子质量肝素（ＬＭＷＨ）钠应用于血液透析的抗凝疗效和安全性。方法：３０例稳定的尿毒症维持性血透患者,随机分为未组分肝素（ＵＦＨ）组和ＬＭＷＨ组。ＵＦＨ首剂４￣６ｍｇ／ｋｇ,追加６￣８ｍｇ／ｈ,透析结束前０．５ｈ停用。ＬＭＷＨ３２００ＩＵ透前一次性ｉｖ。结果：ＬＭＷＨ组秀析器内纤维血栓形成显著较少;用药２和４ｈ血浆ａＸａ活性显著较高,且４与２ｈ比较仅轻度下降;用药后２ｈ血浆部分活化凝     

低分子量肝素治疗不稳定型心绞痛临床观察

目的　观察低分子量肝素 (L MWH)治疗不稳定性心绞痛 (UAP)的疗效及不良反应。方法　选择UAP住院患者 80例 ,随机分为 L MWH治疗组及对照组各 4 0例。治疗组患者皮下注射 L MWH Fraxiparine(速避凝 ) 4 10 0 Axa IU,每日 2次 ,共 10 d;其他治疗包括抗血小板和抗心绞痛等常规治疗。对照组除不用 L MWH外 ,其他治疗与治疗组相同。结果　治疗 15 d后 ,治疗组与对照组治疗总有效率分别为 90 .0 %与 6 7.5 % ;不良心脏事件 (急性心肌梗死与猝死 )发生率分别为 2 .5 %与 2 0 .0 % ;差异有显著性 (P<0 .0 5 )。未见出血等严重不良反应。结论　L MWH治疗 U AP疗效显著 ,无出血等严重不良反应     

地尔硫（zhuo）与低分子肝素联合应用治疗不稳定型心绞痛的临床疗效观察

目的观察静脉滴注地尔硫(艹卓)与皮下注射低分子肝素联合应用治疗不稳定型心绞痛(UA)的临床疗效及其对心率、血压、心电图、心功能的影响.方法46例UA患者起始给予地尔硫(艹卓)剂量为5μg·kg-1·min-1静脉微泵滴注,若心绞痛控制效果不佳可逐步将剂量递增至6～15μg·kg-1·min-1静脉微泵滴注,直至达到最佳疗效后维持48 h;再以其相同剂量每日静脉微泵滴注1次,共3 d;随后改为地尔硫(艹卓)缓释片90 mg口服,每日1次,持续半个月.同时给予低分子肝素(LMWH)5000 U皮下注射,每12 h 1次,共1周.分别在用药前、后对血压(BP)、心率(HR)、心电图(ECG)ST-T及心功能的左心室心输出量(CO)和左心室射血分数(EF)进行监测.结果患者心绞痛能得到及时有效的控制,心率、血压在48 h内与治疗前比较差异有统计学意义(P＜0.05);大部分患者的心电图ST-T缺血性改变得到了纠正或明显改善;左心室心输出量与治疗前比较差异有统计学意义(P＜0.05).在治疗过程中无心血管事件的发生.结论地尔硫(艹卓)与低分子肝素合用治疗UA疗效确切、肯定.     

地尔硫与低分子肝素联合应用治疗不稳定型心绞痛的临床疗效观察

目的观察静脉滴注地尔硫与皮下注射低分子肝素联合应用治疗不稳定型心绞痛(UA)的临床疗效及其对心率、血压、心电图、心功能的影响。方法46例UA患者起始给予地尔硫剂量为5μg·kg-1·min-1静脉微泵滴注,若心绞痛控制效果不佳可逐步将剂量递增至6~15μg·kg-1·min-1静脉微泵滴注,直至达到最佳疗效后维持48h;再以其相同剂量每日静脉微泵滴注1次,共3d;随后改为地尔硫缓释片90mg口服,每日1次,持续半个月。同时给予低分子肝素(LMWH)5000U皮下注射,每12h1次,共1周。分别在用药前、后对血压(BP)、心率(HR)、心电图(ECG)ST-T及心功能的左心室心输出量(CO)和左心室射血分数(EF)进行监测。结果患者心绞痛能得到及时有效的控制,心率、血压在48h内与治疗前比较差异有统计学意义(P<0.05);大部分患者的心电图ST-T缺血性改变得到了纠正或明显改善;左心室心输出量与治疗前比较差异有统计学意义(P<0.05)。在治疗过程中无心血管事件的发生。结论地尔硫与低分子肝素合用治疗UA疗效确切、肯定。     

低分子肝素钙联合血脂康治疗不稳定型心绞痛的临床疗效观察

目的观察低分子肝素钙联用血脂康胶囊治疗不稳定型心绞痛（UAP）的临床疗效。方法不稳定型心绞痛患者88例随机分为对照组（45例）,均采用常规治疗;观察组（43例）给予低分子肝素钙7500Iu12h1次皮下注射,连用7d,合用血脂康胶囊,2粒,2次／d口服,连用14d。观察心脏事件发生以及服药前后血脂、纤维蛋白原（FIB）、外周血白细胞（WBC）的变化。结果观察组无一例进展为急性心肌梗死或死亡,未发现严重出血现象及其它副作用,总有效率92．6％;对照组3例进展为急性心肌梗死（AMI）,总有效率70．4％,两组比较差异有显著性。结论低分子肝素钙联用血脂康治疗不稳定型心绞痛可减少不稳定型心绞痛复发性缺血事件发生,安全有效。     

低分子肝素治疗不稳定型心绞痛

目的：探讨低分子肝素（LMWH）对不稳定型心绞痛（UAP）的疗效。方法：入选111例UAP患者，随机分成LMWH组和普通肝素组（UFH）。LMWH组皮下注射LMWH2500U，2次／d，连续5日，1次／d,2－3日；UFH组皮下注射UFH7500U，2次／d，连续5日，1次／d，2－3日。观察心绞痛发作次数、心电图变化、副作用及实验室指标。 结果：LMWH组与UFH组同样有效控制UAP患者的临床症状，显著降低纤维蛋白原水平；LMWH组有效缓解症状的时间较UFH组短、副作用少，有显著生差异（P＜0．01）。结论：应用LMWH治疗UAP有效、安全、方便。     

参麦注射液联合低分子肝素钙治疗不稳定型心绞痛60例临床观察

目的观察参麦注射液联合低分子肝素钙治疗不稳定型心绞痛的临床疗效及安全性。方法120例不稳定型心绞痛患者在知情同意情况下按人院单双号随机分为观察组（60例）和对照组（60例）,对照组采用心绞痛常规治疗,观察组在对照组治疗的基础上给予参麦注射液联合低分子肝素钙治疗,观察比较两组治疗前后出血时间、凝血时间、凝血酶原时间、心电图变化及临床疗效。结果治疗2个疗程后,观察组有效52例、无效8例、有效率为86．7％,对照组分别为36例、24例、60．0％,两组有效率差异有统计学意义（X2=9．19,P〈0．05）;两组治疗后出血时间、凝血时间、凝血酶原时问等较治疗前差异均无统计学意义（均P〉0．05）;观察组心电图疗效：有效53例、无效7例、有效率88．3％,对照组分别为39例、2l例、65．0％,两组心电图疗效差异有统计学意义（x2=8．83,P〈0．05）。结论参麦注射液联合低分子肝素钙治疗不稳定型心绞痛疗效显著,安全可靠。     

低分子肝素治疗不稳定型心绞痛疗效观察

目的观察低分子肝素治疗不稳定型心绞痛的疗效。方法选择诊断明确的不稳定型心绞痛患者61例，随机分为治疗组（31例）和对照组（30例），对照组采用肠溶阿司匹林、硝酸异山梨酯、倍他乐克等常规药物治疗，治疗组在以上治疗的基础上加用低分子肝素，观察两组对心绞痛的疗效。结果治疗组总有效率93．5％，对照组总有效率70．0％，两组比较有显著差异（P〈0．05）。结论低分子肝素治疗不稳定型心绞痛疗效肯定、安全，优于常规抗心绞痛治疗。