低分子肝素对急性脑梗死患者脑血流的影响  

Effects of LMWH on cerebral blood flow in patients with acute cerebral infarction

作　　者：刘珂[1] 陈玉娟[1] 边伟红[1] 杨红彦[1] 刘学源[1] 

机构地区：[1]同济大学附属第十人民医院神经科,上海200072

出　　处：《同济大学学报（医学版）》2008年第6期67-70,共4页Journal of Tongji University(Medical Science)

摘　　要：目的观察低分子肝素(low molecular weight heparin,LMWH)对急性脑梗死的疗效及对患者脑血流的影响。方法选择90例急性脑梗死患者随机分为两组,LMWH加常规药物治疗组(治疗组)60例,常规药物治疗组(对照组)30例。分别观察治疗前后神经功能缺损评分、日常生活能力(activity of daily life,ADL)评分及脑血流变化。结果治疗后两组神经功能缺损评分及ADL评分较治疗前均有明显好转(P<0.01),但治疗组效果明显优于对照组,有显著性差异(P<0.01);治疗后两组脑血管搏动指数和血管阻力指数明显改善(P<0.01),但治疗组改善更为明显且与对照组比较有显著性差异(P<0.01),两组均未出现明显副作用。结论LMWH治疗急性脑梗死可明显提高临床疗效,其机制可能与其改善局部脑血流量有关。Objective To study the effects of low molecular weight heparin （LMWH） on the curative effect and cerebral blood flow in patients with acute cerebral infarction. Methods Ninety patients with acute cerebral infarction were randomly divided into two groups： control group （n = 30 ） receiving routine drug treatment and treatment group （n = 60） treated with LMWH and routine drug treatment. The changes of the neurological dysfunction score, activity of daily life （ADL） and the level of cerebral blood flow before and after treatment were observed. Results There were significant differences in neurological dysfunction and ADL score before and after treatment in both control and treatment group（ P 〈 0.01 ）. Compared with control group, the neurological dysfunction and ADL score in treatment group improved remarkably（ P 〈 0.01 ）. The vascular pulsatility index （PI） and vascular resistance index （RI） had significant differences before and after treatment in both control and treatment group （ P 〈 0.01 ）. Compared with control group, the PI and RI in treatment group improved more remarkably （P 〈 0.01 ）. There were no obvious side effects in both two groups. Conclusion It is suggested that LMWH could promote the recovery of neural function of patients with acute cerebral infarction, and the mechanism might be related with the improving of regional cerebral blood flow after cerebral infarction.

关 键 词：低分子肝素 急性脑梗死 经颅多普勒 

分 类 号：R743.33[医药卫生—神经病学与精神病学]