低分子肝素治疗短暂性脑缺血发作的疗效观察

Effect of Low Molecular Weight Heparin on Transient Ischaemia Attack

目的探讨在抗血小板治疗基础下加用低分子肝素对短暂性脑缺血发作(TIA)的治疗效果。方法对102例TIA患者进行前瞻性非随机对照研究。对照组54例,给予控制危险因素、阿司匹林50mg、奥扎格雷钠160mg,疗程7～10d;治疗组48例,在上述治疗的基础上加用低分子肝素钠5000U,每日两次脐周皮下注射,疗程7～10d。两组在年龄、性别、分型(颈内动脉系统或椎基底动脉系统)、危险因素、每次症状持续时间以及到治疗时的发病次数均无统计学差异。结果药物治疗30d内,两组的疗效无统计学差异(P>0.05)。随访3个月的结果示:两组间的卒中复发率(包括TIA、脑梗死)、心肌梗死发生率无统计学差异(P>0.05)。治疗组2例齿龈出血,对照组无出血发生。结论在抗血小板治疗基础上,加用低分子肝素未改善TIA治疗效果。

Objective To evaluate the effect of low molecular weight heparin (LMWH) on transient ischemic attack (TIA). Methods It was a prospective,non-random and control study. Total 102 patients suffered from first onset of TIA were included and divided into two groups: 48 cases in LMWH group and 54 cases in control group. Regulating blood pressure,reducing blood sugar,aspirin 50 mg and Ozagrel 160 mg,once per day were all done to all patients. Five thousand units of LMWH were given to patients in treatment group twice a day for 7 to 10 days. Common situations like age,sex,ischemic type(internal carotid artery system or vertebrobasilar artery system),lasting time,times of onset,risk factors had no significant difference between the two groups. Results The curative effect of TIA in the near future and prognosis after 30 days showed no significant difference between the two groups(p>0.05). There was no significant difference between the two groups in the rate of stroke(including TIA recurrence and cerebral infarction) and myocardial infarction after three months. Two patients had gingival bleeding in treatment group and no patient suffered from bleeding in control group. Conclusion Compared with control group,LMWH shows no superiority in therapy of TIA.