低分子肝素与普通肝素或阿斯匹林治疗不稳定型心绞痛疗效比较

目的：比较低分子肝素（LMWH）、普通肝素（H）与阿斯匹林单独及联合治疗不稳定型心绞痛（UAP）病人的疗效。方法：UAP患者156例，随机分为1）阿斯匹林（ASP）组，2）阿斯匹林加普通肝素（ASP＋H）组，3）阿斯匹林加低分子肝素（ASP＋LMWH）组。疗程7天并随访观察3－6个月。结果：ASP＋LMWH组心绞痛缓解率显著高于ASP组（91．8％vs58．2％，P＜0．001），与ASP＋H组（80．8％）比较无显著差异性（P＞0．05）。随访观察期间，ASP＋LMWH组心绞痛复发率显著低于ASP组和ASP＋H组（12．0％vs40．6％、40．5％）。ASP组共有7例发生急性心肌梗死，6例猝死，ASP＋H组共有2例发生出血倾向。三组药物治疗前后部分凝血酶原时间，凝血时间无明显变化（P＞0．05）。结论：阿斯匹林加低分子肝素较单用阿斯匹林或加用普通肝素治疗不稳定型心绞痛疗效更好，更安全。

LOW MOLECULAR WEIGHT HEPARIN VERSUS REGULAR HEPARIN OR ASPIRIN IN THE TREATMENT OF UNSTABLE ANGINA PECTORIS

Aim: To compare the effects and the safety of low molecular weight heparin (LMWH) combined plus aspirin with aspi rin alone or aspirin plus regular heparin in patients with unstable angina pectoris(UAP). Methods: A total of 156 patients with UAP were randomized to receiving aspirin(ASP group), aspirin plus reguler heparin (ASP H group) and aspirin plus LMWH group for one week. All patients were followed-up for 3~6 months. Results: The effective rates during the treatment were 58.2%, 80.8% and 91 .8% of patients in groups ASP, ASP H and ASP LMWH, respectively, and was significantly higher in group ASP LMWH than in group ASP (P<0.001), but no in group ASP H. Recurrent angina occurred in 40.6%,40.5% and 12.0% and were significantly less in ASP LMWH group than in either group ASP (P<0.05) or group ASP H (P<0.05). Acute myocardial infarction and sudden death were present in 7 and 6 patients in ASP group and none in other two groups. Minor bleeding was detected in 2 patients in ASP H group. Conclusion: In this study, treatment with aspirin plus a high dose of low molecular weight heparin during the acute phase of UAP was significantly better than treatment with aspirin alone or aspirin plus regular heparin.