低分子肝素对无症状心肌缺血的治疗  

The effects of low molecular weight heparin on patients with silent myocardial ischemia

作　　者：张瑶琦[1] 张爱萍[1] 洪大庆[1] 夏耘 王荣琥[3] 

机构地区：[1]南京医科大学第一附属医院老年医学科,南京210029 [2]南京医科大学第一附属医院动态心电图室 [3]南京医科大学第一附属医院检验科

出　　处：《临床心血管病杂志》2000年第2期66-68,共3页Journal of Clinical Cardiology

摘　　要：目的 :探讨低分子肝素 (L MWH)在治疗无症状心肌缺血 (SMI)中的临床疗效。方法 :将 6 6例 SMI患者随机分成 A组和 B组 ,每组各 33例 ,均服用抗心肌缺血基础药物 ,A组加用 L MWH0 .4ml(410 0抗 Xa IU) ,每日 1次 ,腹壁皮下注射 ,连续 15 d。B组阿司匹林 75 mg每晚顿服。观察用药前后动态心电图 (DCG)、血液粘稠度、红细胞聚集指数、血小板聚集率、血总胆固醇、甘油三酯等变化。结果 :A组 DCG心肌缺血改善总有效率93.9% ,明显优于 B组 (P <0 .0 0 1)。 A组全血粘度、血浆粘度、全血还原粘度均显著降低 (P <0 .0 1～ 0 .0 0 5 ) ;血小板聚集率显著降低 (P <0 .0 1) ;血总胆固醇、甘油三酯降低显著 (P <0 .0 5 ) ;A组疗效明显优于 B组 (P <0 .0 5～ 0 .0 1)。结论 :L MWH能改善Objective:To study the clinical effect of low molecular werghr heparin (LMWH) on patients with silent myocardial ischemia(SMI).Method:66 patients with SMI were randomly divided into group A (n=33, LMWH 4100 anti XaIu,qd,IH)and group B(n=33,Aspirin 75 mg qN,Po).Basic antimyocardial ischemia drugs were taken by both groups at the same time.Dynamic cardiac graphy (DCG)、blood viscosity、erythrocyte aggregation index、platelet aggregation rate、serum total cholesterol and triglyceride were observed before and 15 days after the treatment.Result:①The efficient rate on improving SMI observing by DCG in group A was up to 93.9 %.Group A was superior to group B (P< 0.001 ),②Total blood viscosity、plasma viscosity and total blood reductive viscosity in group A were significantly decreased (P< 0.01 ～ 0.005 ).Platelet aggregation rate in group A was significantly reduced (P< 0.01 ). Serum total cholesterol and triglyceride in group A were significantly lowered (P< 0.05 ).The above findings in group A were superior to group B.(P< 0.05 ～ 0.01 ).Conclusion:SMI may be improved by LMWH.

关 键 词：低分子肝素 心肌缺血 血液流变学 脂类 

分 类 号：R542.205[医药卫生—心血管疾病]