低分子肝素治疗脑梗死用药时间、疗效和安全性的多中心前瞻性研究  

A multicentral prospective study of the duration of drug administration,ef ficacy and safety in treatment of cerebral infarction with low molecular weigh theparin

作　　者：臧暑雨[1] 陈芷若[1] 李作汉[1] 

机构地区：[1]南京医科大学附属脑科医院神经内科,江苏省南京市210029

出　　处：《中国临床康复》2003年第22期3092-3093,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨缺血性脑卒中患者使用低分子肝素(LMWH)的开始时间、梗死灶部位/大小与疗效的关系和安全性。方法:选取发病24h内自愿入组的急性缺血性脑卒中患者97例,腹部皮下注射低分子肝素(商品名速碧林)0.4mL,2次/d,连用10d。治疗前与治疗后3d做欧洲卒中量表(ESS)评估神经功能缺损,Bathel指数评分评估日常生活活动能力(ADL),复查脑CT/MRI和有关的实验室检查。同时按发病后不同的治疗开始时间、不同梗死部分/大小的梗死灶分组对比ESS和ADL记分。结果:94例患者中91例ESS分明显改善。治疗开始时间<12h,12～24h,>24h,≤48h3组ESS改善分比较(12±11,18±13,14±8,t=0.78,P>0.05),ADL改善分比较(21±15,24±22,23±14,t=1.99,P>0.05),差异均无显著性意义。脑叶、深部梗死ESS改善分比较(18±11vs14±11,t=1.12,P>0.05),ADL改善分比较(27±11比24±20,t=1.80,P>0.05),差异均无显著性意义。梗死灶<1.5cm和>2cm组ESS改善分比较(15±11,20±51,t=0.98,P>0.05),ADL改善分比较(22±15比29±25,t=1.49,P>0.05),差异均无显著性意义。治疗前后实验室检查未见异常,未发现转化为出血性梗死患者,未见不良药物反应患者。结论:缺血性卒中在发病48h内使用LMWH是有效和安全的。AIM:To explore the relationship of the effect and to t he beginning time of treatment,site /size of brain infarction and safety in is chemic stroke p atients with low molecular weight heparin(LMWH).METHODS:Nine ty-seven patients with acute is chemic stroke,52males and45females with an average age of 64.5years,who fell ill within 24hours,were voluntarily i nfused abdominal ly subcutaneously with 0.4mL LMWH every 12hours for 10da ys.Three days before and after treatment,the e-valuation was applied with Eur opean stroke scale(ESS)for nerve function and Barthel index for activities of d aily living(ADL).According to the duration of episode and different site / size of brain infarction,the pat ients were respectively divided to compare ESS and ADL.RESULTS:91cases in 97patients with ischemic stroke had a signific ant improvement in ESS scores.There were no significant difference in ESS an d ADL scores among the groups of treatm ent <12h,12-24h,24-48h ( 12±11,18±13,14±8,t=0.78,P>0.05;21±15,24±2 2,23±14,t=1.99,P>0.05).ESS and ADL scores of lobe and deep part in-farction groups were 18±11,27±11an d 14±11,24±20r espectively,without significant difference(t=1.12,1.80,P>0.05 ).ESS and ADL scores of the group with infarction <1.5cm were 15±11an d 22±15re-spectively,insignificantly diffe rent from those of the group w ith infa rction >2cm(20±51,29±25,t=0.98,1.49,P>0.0 5).Hemorrhagic in-farction and side effect did not occu r in all the patient s

关 键 词：低分子肝素 治疗 脑梗死 用药时间 疗效 安全性 梗死灶部位 

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