低分子肝素钙治疗频发性短暂性脑缺血发作(附38例疗效观察)

Observation on Curative Effect of Frequency TIA Treated with Low Molecular Heparin

目的 观察低分子肝素钙 (速碧林 )对频发性短暂性脑缺血发作 (TIA)的疗效。方法 选择 74例病人 ,随机分为治疗组 (38例 )和对照组 (36例 ) ,治疗组给予速碧林 0 4mL ,2次 /d ,皮下注射 ;对照组给予肠溶阿司匹林 10 0mg ,1次 /d口服。 2组病人常规给予活血化瘀、扩张脑血管、健脑药物治疗 ,7d为 1疗程。结果 治疗组与对照组 1d内TIA发作控制率分别为 6 8 4 2 %和 5 5 5 6 % ;3d内TIA发作控制率分别为97 73%和 80 5 6 % ;治疗期间治疗组发生脑梗死为 1例占 2 6 3% ,对照组为 4例占 11 11% ;2个月内TIA复发率及发展为脑梗死病人对照组明显高于治疗组。血液黏稠度、纤维蛋白原治疗后比较两组有显著差异 (P<0 0 1) ,但凝血酶原时间无明显变化 (P >0 0 5 ) ,治疗组病人均无出血。结论 低分子肝素钙治疗TIA是行之有效的 ,安全系数高 。

Objective To observe the curative effect of frequency TIA treated with low molecular heparin (LMH). Methods 74 cases of frequency TIA patients were divided into 2 groups. The therapy group (38 cases) was treated with LMH 0.4ml b.i.d. subcutaneous injection. The control group was treated with enteric aspirin with both group treated on the basis of routine therapy 7 d as a course. Results The control rates of tow groups were 68.42% and 55.56% in first day. The control rates within 3 days were 97.73% and 80.56%. During therapy, the cerebral infarction was 1 case in therapy group and 4 cases in control group. The incidence at 2 months in control group was significantly higher than that in therapy group in cerebral infarction patient and viscosity and fibrinogen were significantly higher before treatment than those after therapy P<0.05 without change of APTT. Conclusion It might be efficiency and safe in clinic to treat TIA with LMH and should be extensive used.