低分子肝素钠与葛根素合用治疗UAP（不稳定型心绞痛）临床观察

目的观察总结低分子肝素钠与葛根毒哈用时对UAP的治疗效果。方法将60例病人随机分为观察组和对照组各30例。观察组给予吸氧、消心痛、法安明（低分子肝素钠）0．2毫升日2次皮上注射，连用7天。葛根素0．2加入％葡萄糖注射液中日1次静点。10天为一个疗程。对照组给予消心痛、吸氧、丹参静点为主。14天为一个疗程。观察指标：心绞痛控制情况及心电图变化。结果心绞痛控制观察组总有效率90％，对照组73．3％（P〈0．01）。心电图变化观察组总有效率63．3％对照组30％（P〈0．01）。结论低分子肝素钠与葛根素合用治疗UAP可减少发怍（P〈0．01）。心电图缺血ST—T改善明显（P（0．01）。心电图缺血ST—T改善明显（P（0．01）临床收到满意效果。     

不同剂量低分子量肝素治疗高龄不稳定性心绞痛临床观察

目的观察不同剂量低分子量肝素治疗高龄不稳定性心绞痛（UAP）的临床疗效及安全性。方法选择75岁以上不稳定性心绞痛患者48例,随机分为治疗组及对照组。两组均采用常规抗心绞痛治疗;治疗组28例在常规治疗基础上加用低分子量肝素0．4—0．6ml,2次／d,连用7d后改为0．4—0．6ml,10：／a,连用3d。对照组20例在常规治疗基础上加用低分子量肝素0．4～0．6ml,1次／d,连用10d。结果治疗组临床症状总有效率89．28％,与对照组比较差异有统计学意义（P〈0．05）;治疗前后凝血酶原时间（PT）及活动度（PA）、活化部分凝血活酶时间（AVIT）及血小板计数（PLT）均在正常范围内改变（P〉0．05）。结论应用较大剂量低分子量肝素治疗高龄UAP临床疗效显著,安全性好。     

低分子量肝素联合杏丁治疗不稳定性心绞痛的临床观察

目的 观察低分子量肝素(LMWH)联合杏丁注射液治疗不稳定性心绞痛(UA)的疗效及安全性.方法 选择住院治疗的UAP病人139例随机分为3组,常规组46例给予基本抗心绞痛治疗;LMWH组45例在以上治疗基础上加用LMWH5000 u皮下注射,每12 h1次,连用7 d;LMWH加杏丁48例在LMWH基础上联用杏丁注射液(贵州益佰股份有限公司5 ml/支)20～50 ml每日1次,静脉输注,每日1次,共用14 d.治疗后分别观察心绞痛症状、心电图变化及不良反应等.结果 低分子量肝素联合杏丁治疗UA病人后心绞痛症状缓解率及心电图改善率达95.8%,同时病人心肌耗氧量明显下降(P＜0.05).结论 低分肝素联合杏丁治疗不稳定性心绞痛疗效显著.     

国产与进口低分子量肝素治疗不稳定型心绞痛的成本-效果分析

目的比较国产与进口低分子量肝素治疗不稳定型心绞痛的成本-效果。方法对公开发表的治疗不稳定型心绞痛的临床资料,按其给药方案分为国产低分子量肝素（A组）与进口低分子量肝素（B组）两个组,并运用药物经济学原理进行成本-效果比较。结果两种给药方案治疗不稳定型心绞痛具有相同疗效,但成本存在显著差异。结论国产比进口低分子量肝素具有较好的成本-效果比。     

肝素与低分子量肝素治疗不稳定性心绞痛的比较

目的：比较肝素与低分子量肝素治疗不稳定性心绞痛的疗效和安全性。方法：在常规治疗的基础上分为低分子量肝素组６３例，用低分子量肝素注射液０．４～０．６ｍＬ（０．１ｍＬ相当于１０２５ＵＡＸａ），腹壁ｓｃ，ｑ１２ｈ，１０ｄ为一个疗程。肝素组６０例，用肝素５０ｍｇ，大腿前外侧或腹壁ｓｃ，ｂｉｄ，１５ｄ为一个疗程。结果：低分子量肝素组与肝素组心绞痛的复发率和隐匿性心肌缺血的发生率分别为２５％∶４３％和３２％∶４８％，组间比较差别有显著意义，Ｐ＜０．０５。心肌梗死：前组１例；后组３例（死亡１例）。前组未见明显不良反应；后组出血性瘀斑１例。结论：低分子量肝素的疗效和安全性优于肝素     

疏血通注射液治疗不稳定性心绞痛疗效观察

目的：观察疏血通注射液治疗不稳定性心绞痛（UA）的临床疗效。方法：将120例不稳定性心绞痛患者随机分为对照组和治疗组,全部患者常规给予低盐、低脂饮食、休息、吸氧,口服溶阿斯匹林片、β-受体阻滞剂、他汀类降脂药物、硝酸异山梨酯片,静脉滴注单硝酸异山梨酯注射液;治疗组在常规治疗基础上加用疏血通注射液静脉滴注。结果：治疗组和对照组总有效率分别为91．67％和78．33％,经统计学处理两组存在统计学差异（P〈0．05）。结论：在常规治疗基础上加用疏血通注射液治疗不稳定型心绞痛安全有效。     

LMWH联合血栓通治疗UAP及急性非Q波心肌梗死的临床观察

目的：探讨低分子量肝素（LMWH）与血栓通联合用药活疗不稳定型心绞痛（UAP）及急性非Q波心肌梗死的临床效果。方法：将78例UAP及急性非Q波心肌梗死的病人随机分成常规治疗的对照组及治疗组，洁疗组在常规治疗的基础上加用LMWH（法安明）0．2mL脐周皮下注射,q12h：血栓通5mL＋生理盐水10mL iv，qd。两组治疗均为2周。观察心绞痛缓解，缺血性心电图改善及复合终点事件的发生率（死亡＋急性心肌梗死例数）。结果：治疗组心绞痛缓解、缺血性心电图改善总有效率分别为82．5%和75％，复合终点事件的发生率为5％；对照组心绞痛缓解、缺血性心电图改善总有效率分别为60．5％和44．7%。复合终点事件的发生率为15．7%，两组结果比较有统计学意义（P〈0．05）。结论：LMWH联合血栓通治疗UAP及急性非Q波心肌梗死病人疗效好，副作用少，安全有效。     

硝酸异山梨酯注射液治疗冠心病心绞痛

目的：观察国产与进口２种硝酸异山梨酯注射液治疗冠心病心绞痛的疗效。方法：将冠心病心绞痛病人７０例随机分为２组，试验组３５例（男性２１例，女性１４例；年龄５８±ｓ７ａ）用国产硝酸异山梨酯注射液治疗。对照组３５例（男性２７例，女性８例；年龄５８±８ａ）用进口硝酸异山梨酯注射液治疗。２组用药方法均为５０ｍｇ加入５％葡萄糖注射液５００ｍＬ中静脉滴注，ｑｄ，疗程均为１０ｄ。结果：对心绞痛的治疗效果，２组总有效率均为１００％，显效率分别为６６％和６９％；对缺血性心电图表现的疗效，２组总有效率分别为７４％和７７％，显效率分别为２０％和２３％（Ｐ＞０．０５）。不良反应率分别为１４％和１２％。结论：国产与进口硝酸异山梨酯注射液治疗冠心病心绞痛疗效无显著差异。     

低分子肝素钙治疗急性心肌梗死15例

目的：观察低分子肝素钙对急性心肌梗死的疗效,并与肝素钠的疗效进行对比,方法：随机将AMI患者分为治疗组和对照组各15例,在常规治疗基础上,治疗组用低分子肝素钙0．4－0．6mL,腹部皮下注射,bid对照组用肝素钠注射液25mg,静脉滴注,q4h,6d为1个疗程,结果：治疗组梗死后心绞痛发作率12．5％,对照组33．3％,两组比较差异有显著性,结论：低分子肝素钙比肝素钠治疗AMI患者更安全,有效,方便。     

79例不稳定型心绞痛临床治疗探讨

目的：观察血塞通联合低分子肝素钠治疗不稳定型心绞痛的临床效果。方法：对照组给予常规吸氧，卧床休息，合理饮食，肠溶阿司匹林100mg，每晚1次口服，硝苯地平10mg，每日3次口服，单硝酸异山梨酯25mg入5％GS或NS250ml中静滴．20滴／min，每日1次，合并高血压、糖尿病者，给予降压、降糖药物治疗。治疗组在常规治疗的基础上，予以血塞通注射液500mg入5％GS或NS250ml中静滴，每日1次；低分子肝素钠5000U腹壁皮下注射，每12小时1次。低分子肝素钠连续应用7d，两组均14d为1个疗程。结果：①疗效，治疗组总有效率93．6％，对照组总有效率72．2％。两组差异有统计学意义（P〈0．01）；②心电图改善情况，治疗组总有效率91．7％，对照组总有效率67．0％。两组比较．差异有统计学意义（P〈0．01）。结论：低分子肝素钠与血塞通联合治疗不稳定型心绞痛有较好的协同作用．且无明显的毒副作用，疗效显著，值得临床应用。     

低分子肝素治疗不稳定型心绞痛56例

目的：观察低分子肝素（法安明）对不稳定型心绞痛的疗效,方法：100例患者随机分为两组。对照组（44例）给予硝酸异山梨酯、硝苯地平、阿司匹林,复方丹参注射液等常规药物治疗;治疗组（56例）在此基础上加用低分子肝素治疗。结果：临床症状的显效率和总有效率治疗组为82．1％,92．9％,对照组为54．5％,63．6％,两组比较差异极显著（P均＜0．01）;心肌电图改善的总有效率分别为80．4％和50．0％,差异极显著（P＜0．01）。结论：低分子肝素治疗不稳定型心绞痛有显著疗效。     

低分子量肝素联用噻氯匹啶治疗冠心病心绞痛的疗效观察

目的：观察低分子量肝素联用噻氯匹啶和单用噻氯匹啶治疗不稳定心绞痛（UAP）的临床疗效。方法：将59例UAP随机分为治疗组30例和对照组29例，疗程1周。结果：治疗组总有效率为83．33％，对照组N58．62％（P〈0.05）。随访3个月对照组2例发生急性心肌梗死，治疗组1例。两组未发现明显不良反应。结论：在常规治疗基础上加用低分子量肝素能更有效地控制心绞痛发作．减少心肌梗死发生率。     

Effects of a new lipid-based drug delivery system on the absorption of low molecular weight heparin (Fragmin) through monolayers of human intestinal epithelial Caco-2 cells and after rectal administration to rabbits

The effects of a novel drug delivery system, consisting of a lipid matrix and a drug, on the permeability, morphology and drug transport across monolayers of human intestinal epithelial cells were investigated. A 1:3 mixture (w/w) of chromatographically purified soybean phosphatidylcholine and medium chain monoacylglycerol was chosen as lipid matrix (PC:MG) and mannitol (mol. wt. 182) and Fragmin (low molecular weight heparin; mean mol. wt. 5000) were chosen as hydrophilic model drugs. PC:MG had an immediate and dose-dependent effect on the permeability of the cell monolayers, and on epithelial morphology (as seen under transmission electron microscopy). PC:MG (4–10 mM) dose-dependently enhanced the transport rate of mannitol and Fragmin, causing an approximately 10-fold increase in the transport rate of Fragmin at concentrations of 6–8 mM. The increase was independent of the dose of Fragmin and was reversible in concentrations up to 6 mM. At higher doses, clear effects on the apical cell membranes were observed although the tight junctions remained intact. PC:MG also enhanced Fragmin absorption in vivo after rectal administration to New Zealand White rabbits. Co-administration of Fragmin with PC:MG (7 mM) resulted in an increase in the relative bioavailability (compared with s.c. administration) from < 1% (without PC:MG) to 21 ± 12%. A maximal increase in relative bioavailability to 90 ± 19% was obtained at a PC:MG concentration of 35 mM. Thus, PC:MG functions as an absorption enhancer both in the cell monolayer model and in vivo, in the same concentration range. The results indicate that as well as providing mechanistic information, studies of absorption enhancers in Caco-2 monolayers also provide information on suitable dosage regimens for in vivo studies.     

Low-molecular-weight heparin may alter point-of-care assay for international normalized ratio

STUDY OBJECTIVE: To compare the international normalized ratio (INR) measured by a point-of-care testing device with that measured by a reference laboratory method for patients receiving either warfarin only or warfarin plus low-molecular-weight heparin (LMWH). DESIGN: Retrospective study. SETTING: Outpatient anticoagulation clinic. SUBJECTS: Ninety-one patients receiving warfarin for various indications; 59 of them receiving only warfarin and 32 receiving warfarin plus LMWH. INTERVENTION: Capillary blood was obtained for INR determination by a point-of-care device, and venous blood was obtained for INR determination in a standard reference laboratory. MEASUREMENTS AND MAIN RESULTS: Ninety-one patients had INR pairs run on a point-of-care device and by the laboratory. In both the patients receiving only warfarin and in those receiving warfarin plus LMWH, the mean INR as determined by the point-of-care testing device was statistically significantly higher than the mean INR determined by the laboratory. Although the differences were statistically significant in both groups, the clinical significance of this difference was accentuated in the patients receiving warfarin plus LMWH. The measure of divergence between the point-of-care and laboratory methods was greater in the group receiving warfarin plus LMWH than in the warfarin-only group, with a mean +/- SD percent change between the INR values of 24.19 +/- 27.54% in the warfarin plus LMWH group and 7.21 +/- 17.73% in the warfarin-only group. In assessing the clinical impact of such variability, a greater degree of discordance in dosing adjustment decisions was noted for patients receiving warfarin plus LMWH. In this group, a 25% rate of discordance was noted compared with 8% in the warfarin-only group. Such discrepancy in dosing decisions based on the point-of-care INR would have resulted in discontinuation of LMWH therapy before the patient acquired a true therapeutic INR, with use of the laboratory measurement. CONCLUSION: The INR measured with the point-of-care device in patients receiving concurrent LMWH and warfarin therapy may be inaccurate. Patients receiving LMWH in addition to warfarin should have INRs checked by means of the standard reference laboratory method.     

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。     

低分子肝素钙治疗不稳定型心绞痛81例临床观察

目的观察低分子肝素钙治疗不稳定型心绞痛的临床疗效。方法162例不稳定型心绞痛患者按人院顺序随机分为对照组和治疗组各81例。2组患者均接受常规治疗,在此基础上治疗组患者加用低分子肝素钙0．1ml／10kg（851U／kg）,腹壁皮下注射,1次／12h,连用14d。结果治疗组总有效76例（93．8％）,高于对照组的60例（74．0％）,差异有统计学意义（P〈0．05）。治疗组心绞痛发作次数、持续时间、发作间隔时间、硝酸甘油用量心电图结果及血液流变学等改善情况均优于对照组,差异有统计学意义（P〈0．05或P〈0．01）。结论低分子肝素钙治疗不稳定型心绞痛具有较好的疗效,改善了不稳定型心绞痛患者的近期预后,且治疗过程中未见明显不良反应。     

速避凝治疗急性脑梗塞疗效观察

目的 探讨速避凝治疗急性脑梗死的临床疗效及副作用发生率。方法 设实验组与对照组,实验组30例使用速避凝,对照组30例使用右旋糖酐。结果 速避凝组30例,显效率为90％,有效率为93％。对照组30例,显效率为47％,有效率为80％,速避凝除4例治疗局部青紫、1例牙龈出血外,无其他不良反应、结论 述避凝治疗急性脑梗死疗效肯定,副作用小。     

低分子肝素与黄芪当归合剂联用治疗难治性肾病综合征的疗效观察

目的探讨低分子肝素与黄芪当归合剂联用对难治性肾病综合征（RNS）患者尿蛋白、血浆白蛋白、血肌酐和胆固醇的影响。方法将60例患者随机分为治疗组、对照组各30例。对照组给予泼尼松及环磷酰胺（CTX）治疗,治疗组给予激素、CTX治疗的同时,另予低分子肝素联合黄芪当归剂治疗。在治疗第8,12周时分别检测各组尿蛋白、血浆白蛋白、血肌酐和胆固醇。结果与对照组比较,治疗组的尿蛋白,血肌酐（Scr）和胆固醇明显下降（P〈0．05）,血浆白蛋白显著回升（P〈0．05）。结论在治疗难治性肾病综合征患者方面,低分子肝素与黄芪当归合剂联用比激素和CTX更能有效降低尿蛋白。血肌酐和胆固醇,增加血浆白蛋白水平。     

头孢哌酮的药物动力学及药效学

对比国产和进口头孢哌酮的药物动力学，为临选药提供依据。结果两组的药学参数、ＭＩＣ值及有效率均无统计学差异。结论：国产和进口头孢哌酮的药物动力学及药效学相似。