低分子肝素治疗高原老年急性冠状动脉综合征患者的临床研究  

Therapeutic effect of low-molecular-weight heparin in elderly patients at high altitude with acute coronary syndrome

作　　者：陈丽娴[1] 姜大春[1] 尹刚[1] 虞慎也[1] 吴鹏[1] 李德生[1] 甘俊[1] 

机构地区：[1]解放军第37医院心内科,雅安625000

出　　处：《中华老年多器官疾病杂志》2013年第3期193-196,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的观察低分子肝素治疗高原老年急性冠脉综合征（ACS）患者的疗效及安全性。方法将90例老年ACS患者随机分为常规治疗组（n=42）和延长低分子肝素治疗组（n=48），常规治疗组采用低分子肝素（依诺肝素）皮下注射治疗5～7d，延长低分子肝素治疗组治疗10～14d，其余基础治疗相同。观察30d内心血管事件、出血事件和血小板减少的发生率。结果常规治疗组30d内心血管事件的发生率为19．0％，延长治疗组为4．2％，两组间差异有统计学意义（P〈0．05）；常规治疗组30d内出血事件的发生率为4．8％，延长治疗组为6．3％，两组间差异无统计学意义（P〉0．05）；两组患者中均未观察到血小板减少的发生。结论延长使用（10～14d）低分子肝素治疗高原老年ACS可显著降低30d内心血管事件的发生率，且不增加出血风险和血小板减少事件的发生率。Objective To observe the effectiveness and safety of low-molecular-weight heparin in treatment of elderly patients with acute coronary syndrome （ACS） at high altitude. Methods Ninety elderly patients with ACS who were hospitalized in our department from April 2008 to October 2012 were randomly divided into conventional therapy group （n = 42） and delayed therapy group （n = 48）. Patients in conventional group received subcutaneous injection of low-molecular-weight heparin for 5 to 7d, while those in delayed group received same treatment but with duration lasting for 10 to 14d. The basic therapy was similar between the two groups. The incidence of cardiovascular events, hemorrhage and platelet reduction within 30d were recorded. Results The incidence of cardiovascular events within 30d was significantly higher in conventional group than in delayed group （19.0% vs 4.2%, P 〈 0.05）. The incidence of hemorrhage was similar between the two groups （4.8% vs 6.3%, P〉 0.05）. No reduction in platelet count was observed. Conclusion The strategy of delayed therapy with low-molecular-weight heparin in elderly patients at high altitude with ACS significantly decreases the incidence of cardiovascular events within 30d, but has no effect on hemorrhage risk.

关 键 词：高原 老年人 低分子肝素 急性冠脉综合征 

分 类 号：R541.4[医药卫生—心血管疾病]