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延长使用低分子肝素治疗高原非ST段抬高型急性冠脉综合征的临床观察

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2011年第6期
页码:
767-769
栏目:
临床研究
出版日期:
2011-12-25

文章信息/Info

Title:
Clinical observation of delayed therapy with low molecular weight heparin in patients with non-ST segment elevation acute coronary syndrome at high altitude
作者:
吴久健1; 姜大春2; 尹 刚2; 虞慎也2; 吴 鹏2; 石国芹2
解放军第三十七医院:1.药械科，2.心内科，四川 雅安 625000
Author(s):
WU Jiu-jian1;  JIANG Da-chun2;  YIN Gang2;  YU Shen-ye2;  WU Peng2;  SHI Guo-qin2
1.Department of Drug and Equipment, 2.Department of Cardiology, PLA 37 Hospital, Ya’an 625000, Sichuan, China
关键词:
高原; 低分子肝素; 急性冠脉综合征
Keywords:
high altitude;  low molecular weight heparin;  acute coronary syndrome
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的:观察延长使用低分子肝素治疗高原非ST段抬高型急性冠脉综合征(NSTE-ACS)患者的疗效及安全性。方法: 将85例NSTE-ACS患者随机分为常规治疗组(n=42)和延长治疗组(n=43)，常规治疗组采用低分子肝素(依诺肝素)皮下注射治疗5～7 d，延长治疗组治疗10～14 d，其余基础治疗相同。观察30 d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30 d内心血管事件的发生率为19%，延长治疗组为5%，两组间有显著差异(P＜0.05)；常规治疗组30 d内出血事件的发生率为5%，延长治疗组为5%，两组间无显著差异；两组患者中均未观察到血小板减少和APTT延长的发生。结论: 延长使用(10~14 d)低分子肝素治疗高原NSTE-ACS可显著降低30 d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。
Abstract:
AIM:To observe the effectiveness and safety of delayed therapy with low molecular weight heparin (LMWH) in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS) at high altitude. METHODS: Eighty-five patients with NSTE-ACS were randomized into conventional therapy group (n=42) and delayed therapy group (n=43). Patients in conventional group received LMWH therapy for 5 to 7 days, whereas patients in delayed group received LMWH for 10-14 days. The basic therapy was similar in both groups. The incidences of cardiovascular events, hemorrhage and platelet reduction within 30 days were recorded. RESULTS: The incidence of cardiovascular events within 30 days in conventional group was significantly higher than that in delayed group (19.0% vs. 4.7%, P<0.05). The incidence of hemorrhage was similar between groups (4.8% vs. 4.7%, P>0.05). No reduction in platelet count and no increase in activated partial thromboplastin time (aPTT) were observed. CONCLUSION: The strategy of delayed therapy with LMWH will significantly decrease the incidence of cardiovascular events in patients with NSTE-ACS at high altitude within 30 days and will not significantly increase hemorrhage risks.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2011-02-10.基金项目：成都军区医学科研计划课题(MB09016) 通讯作者：姜大春，副主任医师，主要从事冠心病的临床研究Email:jiangdc@sohu.com 作者简介：吴久健，副主任医师Email:drwjj@yahoo.cn
更新日期/Last Update: 2011-12-27