低分子肝素钙治疗伴发呼吸-睡眠暂停综合征的急性脑梗死73例疗效分析

目的观察低分子肝素钙治疗伴发呼吸-睡眠暂停综合征的急性脑梗死的疗效.方法73例伴发呼吸-睡眠暂停综合征的急性脑梗死患者随机分成2组.治疗组（38例）用低分子肝素钙5000U于腹壁皮下注射,每日2次,共用10～14天.对照组（35例）除低分子肝素钙治疗外所有治疗与治疗组相同.分别观察治疗前后两组血气分析、血流变学、凝血酶原时间、血小板及纤维蛋白原的改变及临床疗效.结果治疗组和对照组比较,治疗组PaCO2降低和PaO2提高明显,而对照组除PaO2升高外,PaCO2无变化.治疗组凝血酶原时间、血小板及纤维蛋白原均较治疗前有明显改善.2组治疗后比较,治疗组凝血酶原时间、纤维蛋白原均比对照组有显著改善（分别P＜0.01,P＜0.05）.治疗组总有效率及显效率分别为84.21%、65.79%,对照组总有效率及显效率分别为68.57%、42.86%.两组比较差异非常显著（P＜0.01）.2组未发现脑出血.结论低分子肝素钙治疗脑梗死伴发呼吸-睡眠暂停综合征安全且疗效确切.

The analysis about 73 cases treatment of acute-cerebral infarction accompanied with sleep apnea syndrome by hyponumerator heparin calcium

Objective Observe the curative effect of acute-cerebral infarction accompanied with sleep apnea-syndrome by hyponumerator heparin calcium. Methods divide 73 patients who catch acute-cerebral infarction accompanied with apnea-syndrome into 2 group. The be treated group (38 cases ) hyodermic 5000u hyponumerator heparin calcium in abdominal wall, bid, about 10-14 days. The control group(35 cases) all the therapeutic methods are same as the be treated group except the hyponumerator heparin calcium. Observe two groups blood gas analysis, blood rheology, prothrombin tim,e blood platelet and fibrinogen's change and curative effect. Results compare the two groups, the be treated group PaCO2 bring down and PaO2 notability ascend. The control group PaO2 ascend and PaCO2 unchanged. The be treated group's prothrombin time, blood platelet and fibrinogen notability improvement. Compare the two group after treat, the 1st group's prothrombin time and fibrinogen are better than the 2nd group's(P<0.01, P<0.05). 1st group's effective rate is 84.21% apparent rate is 65.79%, 2nd group's effective rate is 68.57% apparent rate is 42.86%. the two group's difference is very predominance(P<0.01). there's no cerebral hemorrhage in the two group. Conclusions treat acute-cerebral infarction accompanied with sleep apnea-syndrome by hyponumerator heparin calcium is safety and efficiency.