低分子肝素治疗不稳定型心绞痛41例临床观察

Clinical Observation of 41 Cases Unstable Angina Pectoris Treated with Low-molecular-Weight Heparin

目的：探讨低分子肝素治疗不稳定型心绞痛（UA）的临床疗效。方法：对41例不稳定型心绞痛病例，治疗前均常规治疗。在此基础上低分子肝索（体重≤60kg为5000U，体重〉60kg为7500U），12h1次皮下注射，连用7～14d，分别于用药前30min，用药后48h采血测定活化部分凝血活酶时间（APTT），凝血酶原时间（PT）。结果：显效9例，有效24例，总有效率80．5％。结论：低分子肝素具有高比例的抗因子Xa和抗因子Ⅱa活性，由于其分子量小，与血浆蛋白和内皮细胞结合减少。所以生物利用度高，血浆半衰期长。疗效可取得与肝素同样甚至更高抗凝血酶效果，并且有发生严重出血事件低的优点。

Objective： To observe the clinical curative effects of low-molecular-weight heparin for the unstable angina pectoris. Methods： Forty-one cases with the unstable angina pectoris received routine treatment and low-molecular-weight heparin （weigh〈60 kg were given 5 000 U,weight〉 60 kg at 7 500 U given by hypodermical injection every 12 h）. Time of therapy were 7-14 day. APTT and PT were measured respectively in 30 minutes before or 48 hours after therapy. Results：Nine cases gained obviously effect, 24 cases gained effect. The total effective rate was 80.5 %. Conclusion： Low-molecular-weight heparin may have specific anti-Xa and anti- Ⅱa. Its bonding to plasma protein and blood vessel endothelium are small,so low-molecular-weight hepatin have highly bioavailability and long plasma half-life. As compared with ordinary heparin, lowmolecular-weight heparin has the same or even preferably therapeutic effect with less severe bleeding.