低分子肝素延长疗程治疗不稳定型心绞痛疗效观察

摘要

目的：观察低分子肝素延长疗程治疗不稳定型心绞痛的疗效。方法：同期入院的不稳定型心绞痛患者168例，随机分为2组，均在常规治疗基础上应用低分子肝素(立迈青)皮下注射，每日2次。A组应用1周，B组应用3周，第1周用量2组均为每次120 IU/kg，第2～3周B组用量每次100 IU/kg。结果：早期(第7日)观察2组总有效率分别为75.9%、77.4%，疗效无显著差异(P>0.05)；心血管意外事件(急性心肌梗死、心脏性或非心脏性死亡、药物无法控制病情需行急性血运重建术)及出血，在2组的发生率无显著差异(P>0.05) 。晚期(第8～30日)观察2组总有效率分别为87.2%、97.5%，有显著性差异(P<0.05)；心血管意外事件发生率A组高于B组(P<0.05)；2组出血发生率无显著差异(P>0.05) 。结论：低分子肝素延长疗程治疗不稳定型心绞痛疗效较短程应用疗效为好，且不增加出血发生率。%Objective:To observe the curative effect of low molecular weight heparin of prolongable curative course on treating unstable angina pectoris.Methods:One hundred and sixtyeight cases with unstable angina pectoris who were admitted into hospital at the same period were randomly divided into two groups.Both groups were subcutaneously injected by low molecular weight heparin combined with conventional therapy,two times a day for one week in group A and three weeks in group B respectively.In the first week,the dosage of heparin in group A and B was 120 IU/kg every time,from second to third week,the dosage of heparin in group B was 100 IU/kg every time.Results:The total effective rates in group A and group B were 75.9% and 77.4% respectively in early stage (seventh day),and the difference was not significant (P>0.05).The incidences of cardiovascular accidental events (acute myocardial infarction,cardiac death,uncardiac death,the illness which could not be controlled by the medicine and should be treated with acute reconstruction of blood circulation) and haemorrhage in both groups had not significantly different (P>0.05).The total effective rates in group A and group B were 87.2% and 97.5% in advanced stage(eighth to 30th days) respectively,there was significantly difference (P<0.05).The incidence of cardiovascular accidental events in group A was higher than that in group B(P<0.05).The incidence of haemorrhage had not significantly different (P>0.05).Conclusions:The curative effect of low molecular weight heparin prolongable curative course is better than that with short curative course,and haemorrhagic incidence is not increased.