低分子量肝素与阿司匹林合用治疗急性脑梗死  

Low-molecular weight heparin plus aspirin for acute cerebral infarction

作　　者：陈宪琪[1] 孙顺昌[1] 王利英[1] 

机构地区：[1]青岛市第八人民医院神经内科,山东青岛266100

出　　处：《南京军医学院学报》2002年第3期159-161,共3页Journal of Nanjing Military Medical College

摘　　要：目的 :研究低分子量肝素 (速避凝 )与阿司匹林联合应用治疗急性脑梗死的疗效 ,以及对凝血功能的影响 ,继发性脑出血的发生率。方法 :采取随机对照临床试验。速避凝合用阿司匹林 (治疗组 6 4例 )及单用阿司匹林 (对照组 6 1例 )治疗发病2 4h以内的急性脑梗死病人 12 5例。在速避凝合用阿司匹林治疗前及用药后第 14天分别进行神经功能缺损评分 ,在病人出院时和第 12周进行两次病人日常生活能力评估 (Barthel指数 ) ,并检测凝血功能、脑出血并发率及肝功、肾功。结果 :治疗组凝血酶原活动度在用药后显著降低 (P <0 .0 5 ) ,但引发脑出血的发生率无统计学差异 ,近期疗效治疗组显著优于对照组 ,第 14天神经功能缺损评分及出院时Barthel指数治疗组较对照组有显著进步 (P <0 .0 5 ) ,对肝功、肾功无影响。结论Objective:To study the effectiveness of Low molecular weight heparin (fraxiparine) plus aspirin in the treatment of acute cerebral infarction and the effect on coagulant function as well as the incidence of cerebral hemorrhage. Methods:In a randomized, controlled clinical trial, 125 patients with acute cerebral infarction were treated within 24 hours. They were treated with fraxiparine plus aspirin ( n =64 in the treated group) and aspirin alone ( n =61 in the control group). The nerve function deficit scores were evaluated before the treatment and after 14 days of the fraxiparine plus aspirin treatment, the activities of daily living (Barthel index) of the patients were evaluated at the time of discharge and the 12th week, and the coagulant function and the risk of cerebral hemorrhage, liver function and nephritic function were tested. Results:The prothrombin activity (A) of the treated group decreased significantly after the treatment ( P <0.05), but there was no significant difference in the incidence of cerebral hemorrhage. The treated group was significantly better than the control group. There was significant difference between the two groups in neurological deficit scores on day 14 and the Barthel index at discharge ( P <0.05). They did not harm the hepatic and nephritic function. Conclusion:Fraxiparine plus aspirin in the treatment acute ischemic stroke is better than aspirin alone.

关 键 词：低分子量肝素 阿司匹林 急性脑梗死 联合治疗 疗效分析 

分 类 号：R973.2[医药卫生—药品] R743.33[医药卫生—药学]