低分子肝素治疗急性脑梗死84例疗效观察

目的观察低分子肝素（LMWH）治疗急性脑梗死的疗效及安全性。方法治疗组和对照组各84例均使用血栓通和胞二磷胆碱作基础治疗,治疗组加用LMWH 5 000AXaIU,腹壁皮下注射,1次/12 h,连用10d。两组病例于治疗前、治疗第21天分别进行巴氏指数（BI）与中国卒中量表（CSS）评分及疗效评定。于治疗第10天复查颅脑CT及凝血功能,并观察LMWH治疗期间的不良反应。结果两组治疗第21天CSS和BI评分均有所改善,但治疗组明显优于对照组（P〈0.05）。治疗组总有效率为88.1%,明显优于对照组的65.5%（P〈0.05）。治疗组颅内出血2例,均为无症状性。凝血功能的变化与对照组比较差异无统计学意义。未发现血小板减少症等副作用。结论低分子肝素治疗急性脑梗死是安全有效的。

Effects of low-molecular-weight heparin on acute cerebral infarction

Objective To observe the efficacy and safety of low-molecular-weight heparin（LMWHi）n the treatment of acute cerebral infarction.Methods LMWH was given subcutaneously for 10 days to treat 84 patients（5000AXaIU,q12h）and there were 84 randomized patients as control.All patients were treated with Xueshuantong and Citicoline.Barthel index（BI）and Chinese Stroke Scale（CSS）and the efficacy in the two groups were assessed at different time points before treatment and at the 21st day after treatment.All cases took brain CT and fibrinogen by fol-low-up examinations at the 10 th day,and the adverse reaction associated with the LMWH treatment were observed.Results The results of CSS and BI of two groups improved at the 21st day after treatment,and CSS and BI of the treatment group was better than those of the control group（P0.05.）The total effective rate was 88.1% in the LMWH group and it was significantly greater than 65.5% in the control group（P0.05.） Asymptomatic spontaneous intracrani-al hemorrhage was found in 2 patients with LMWH treatment.The change of fibrinogen was no significant difference from the control group.No serious complication was found such as bleeding,heparin-induced thrombocytopenia and so on.Conclusion LMWH is safe and effective in the treatment of acute cerebral infarction