低分子肝素与前列腺素E_1合用治疗不稳定性心绞痛临床观察

目的:观察低分子肝素与前列腺素E1合用治疗不稳定性心绞痛的疗效。方法:选择2006年10月～2009年10月我院收治的128例不稳定性心绞痛患者,随机分为3组:A组43例,基本治疗+低分子肝素+前列腺素E1;B组43例,基本治疗+低分子肝素;C组42例,基本治疗+前列腺素E1。观察3组治疗后心绞痛缓解与缺血性ST-T恢复情况;前列腺素E1、低分子肝素副作用;3组治疗前后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血浆纤维蛋白原(FIB)、D-二聚体情况。结果:A组与B、C组住院后7d内心绞痛缓解率比较有显著性差异(P均<0.01);A组与B、C组缺血性ST-T改变恢复率比较有显著性差异(P均<0.05)。3组前列腺素E1致输注静脉不适、疼痛和药源性静脉炎发生率分别为A组23.26%、2.33%,B组未见副作用发生,C组为19.05%、4.76%;3组低分子肝素致注射部位瘀斑发生率A组为88.37%,B组未见副作用发生,C组为90.70%。3组治疗前后PT、APTT、FIB、D-二聚体情况均在正常范围内。结论:低分子肝素与前列腺素E1合用治疗效果优于单用低分子肝素或单用前列腺素E1治疗效果,且副作用发生率低。

Clinical Observation of Low Molecular Weight Heparin and PGE_1 in the Treatment of Unstable Angina Pectoris

OBJECTIVE：To observe the therapeutic effectiveness of low molecular weight heparin combined with PGE1 in the treatment of unstable angina pectoris（UAP）.METHODS：Select Oct.2006 to Oct.2009 in our hospital,128 cases of UAP were randomly divided into 3 groups.Group A（43 cases）were given general treatment,low molecular weight heparin and PGE1.Group B（43 cases）were given general treatment and low molecular weight heparin.Group C（42 cases）received general treatment and PGE1.Remission of angina pectoris and the recovery rate of ischemia ST-T segment were observed as well as side effects of low molecular weight heparin and PGE1.The levels of PT,APTT,FIB and D-Dimer in 3 groups were measured before and after treatment.RESULTS：The relief rate of group A was significantly different from that of group B and group C on 7 days after admission（P0.01）.The recovery rate of ischemia ST-T segment in group A was significantly different from that of group B and group C（P0.05）.The incidence of discomfort and pain of vein and drug-induced phlebitis caused by PGE1 were 23.26% and 2.33% for group A and 19.05% and 4.76% for group C.No side effect was found in group B.The incidences of ecchymosis of injection site caused by low molecular weight heparin were 88.37% for group A and 90.70% for group C while no side effect was found in group B.The level of PT,APTT,FIB and D-Dimer of 3 groups were kept in normal range.CONCLUSION：Low molecular weight heparin combined with PGE1 is better than low molecular weight heparin or PGE1 with low incidence of side effect.