低分子肝素钙联合阿司匹林治疗频发短暂性脑缺血发作的效果

目的探讨低分子肝素钙联合阿司匹林治疗频发短暂性脑缺血发作（TIA）的临床效果。方法选取2012年6月-2013年5月来本院就诊的频发TIA患者60例,随机分为治疗组及对照组,各30例。对照组给予阿司匹林口服治疗,治疗组在对照组基础上加用低分子肝素钙皮下注射,比较两组的临床疗效、症状积分、治疗前及治疗7和14 d的PT、APTT、全血高切黏度、全血低切黏度、FIB、PLT计数及不良反应发生率。结果治疗组的总有效率为96.67%,对照组总有效率为63.33%,两组比较差异有统计学意义（P〈0.01）。随访6个月,治疗组未见TIA复发及脑梗死发生,对照组TIA复发7例、脑梗死5例。治疗组治疗7、14 d的PT、APTT均长于治疗前,全血高切黏度、全血低切黏度均低于治疗前,差异有统计学意义（P〈0.05）。治疗后,治疗组的短暂性失语、瘫痪及感觉障碍评分均高于对照组,差异有统计学意义（P〈0.05）。两组皆无明显不良反应。结论低分子肝素钙联合阿司匹林治疗频发TIA的临床效果显著,安全可靠,副作用较小,值得临床推广应用。

Effect of low molecular weight heparin calcium combined with aspirin in the treatment of frequent transient ischemic attack

Objective To explore effect of low molecular weight heparin calcium combined with aspirin in the treatment of frequent transient ischemic attack（TIA）. Methods 60 patients with frequent TIA from June 2012 to May 2013 in our hospital were collected and randomly divided into treatment group and control group with 30 cases in each group.The aspirin treatment was used in control group,low molecular heparin subcutaneous injection based on control group was applied in treatment group.The clinical efficacy,symptom score and PT,APTT,whole blood high shear viscosity,whole blood low shear viscosity,FIB,PLT before treatment and 7 and 14 days of treatment and adverse reaction in two groups were compared. Results The total effective rate of treatment group was 96.67%,while total effective rate of control group was 63.33%,with statistical difference（P〈0.01）.Followed up of 6 months,the treatment group had no recurrence of TIA and cerebral infarction,control group had 7 cases of TIA and 5 cases of cerebral infarction.Treatment of 7 and 14 days,PT and APTT in treatment group was longer than that before treatment respectively,whole blood high shear viscosity,whole blood low shear viscosity in treatment group was lower than that before treatment respectively,with statistical difference（P〈0.05）.After treatment,transient aphasia,paralysis and sensory disorder score in treatment group was higher than that in control group respectively,with statistical difference（P〈0.05）.The two groups had no obvious adverse reaction. Conclusion Low molecular weight heparin calcium combined with aspirin in the treatment of frequent TIA has remarkable clinical effect,safe and reliable,less side effect,it is worthy of clinical promotion and application.