国产低分子量肝素钙立迈青治疗不稳定型心绞痛和非Q波心肌梗死的临床观察  

Clinical Studies on National Low Molecular Weight Heparin-Livaracine in Therapy Acute Coronary Syndrome

作　　者：李卫华[1] 杜修海[1] 胡静冷[1] 张明旭[1] 马菱[1] 

机构地区：[1]兰州军区总医院心内科,兰州730050

出　　处：《中国动脉硬化杂志》2001年第5期424-426,共3页Chinese Journal of Arteriosclerosis

摘　　要：为观察国产低分子量肝素钙———立迈青治疗不稳定型心绞痛或非Q波心肌梗死的有效性和安全性 ,选择不稳定型心绞痛或非Q波心肌梗死患者 ,分别予肝素和低分子量肝素钙立迈青治疗。观察各组临床症状及心电图的改善 ;实验室检查活化的部分凝血活酶时间、纤维蛋白原含量及血小板计数 ;观察复合终点事件。结果发现 ,治疗 7天两组用药期间平均胸痛发作次数差异无显著性 ,但肝素组需口服硝酸甘油缓解胸痛的患者较立迈青组增加 ;治疗 14天立迈青组复合终点事件明显低于肝素组 ;且出血事件明显少于肝素组。以上提示 ,立迈青皮下注射与活化的部分凝血活酶时间监测的连续静滴肝素具有同样疗效 ;且立迈青可明显减少急性冠状动脉综合征的各种心血管事件的发生 ,更少发生出血事件 ,因此在临床抗血栓治疗中具有广泛的应用前景。Aim To evaluate the efficacy and safety of the national low molecular weight heparin (LWMH)-Livaracine in treating acute coronary syndrome compared with standard heparin (SH). Methods In a randomized clinical trial, 84 patients, with at least one attack of ischemic chest pain by unstable angina or non-Q wave myocardial infarction within 72 h before treatment enrolled, were divided into two groups, group SH: intravenous SH 5 000 IU, twice daily to maintain the APTT or ACT at 1.5～2.0 times of control for 7 days and group LMWH: subcutaneous Livaracine 5 000 IU, twice daily for 7 days. All patients took 150 mg asprins daily at the same time. The primary indexes were the improvement of clinical symptoms and ECG, composite events (acute myocardial infarction,cardiac or noncardiac death and urgent revascularization) and adverse reaction. The patients enrolled should stay in hospital for at least 14 days. Results By 7 days, the incidence of angina pectoris was not significant between the two groups, but more patients needed oral nitroglycerin for pain relief in group SH. By 14 days, composite events were singificantly reduced in group LWMH than in group SH. Serious bleeding was very few in patients receiving LWMH. Conclusions Subcutaneous Livaracine is at least as effectural as continuous intravenous SH for the suppression of heart attacks in the early and late phase of acute coronary syndrome. LMWH is more effective in reducing composite cardiovascular events 14 days after drug initiation. Monitoring is not necessary in the routine use of LMWH, which shows more convenience and ease of use.

关 键 词：低分子量肝素 立迈青 冠状动脉综合征 不稳定型心绞痛 心肌梗死 治疗 

分 类 号：R541.405[医药卫生—心血管疾病]