低分子肝素联合舒血宁治疗伴颈动脉斑块的脑梗死临床研究

Study the Effect of Low-molecular-weight Heparins Combined with Shuxuening Injection in the Treatment of Cerebral Infarction Accompanied with Carotid Atherosclerosis

目的:观察低分子肝素治疗脑梗死和颈动脉斑块的疗效和安全性,并对不同剂量作对比研究。方法:伴颈动脉粥样斑块的急性脑梗死患者150例,随机分为3组:低分子肝素钙注射液大剂量组、低分子肝素小剂量钙注射液组和对照组,各50例。对照组予生理盐水250mL+舒血宁20mL,静滴,qd,疗程14d。大剂量组在对照组治疗的基础上予低分子肝素钙注射液1mL,5000AXaIU,皮下注射,每日2次,连用14d。小剂量组在对照组治疗的基础上予低分子肝素钙注射液1mL,5000AXaIU,皮下注射,每日1次,连用14d。结果:舒血宁、大剂量低分子肝素或小剂量低分子肝素联合舒血宁均能显著缩小颈动脉粥样硬化斑块(P<0.01),且大剂量低分子肝素联合舒血宁对脑梗死的疗效优于小剂量低分子肝素联合舒血宁组,小剂量低分子肝素联合舒血宁组的疗效优于单纯舒血宁治疗组治疗组,大剂量低分子肝素联合舒血宁较剂量低分子肝素联合舒血宁组或单纯舒血宁治疗组显著减少脑梗死的复发。低分子肝素联合舒血宁治疗中,未见严重出血情况。结论:大剂量低分子肝素钙注射液联合舒血宁治疗脑梗死和颈动脉粥样硬化疗效肯定,且能减少脑梗死的复发,无严重副作用。

Objective： To compare the clinical effects and safety of different dosages of low-molecular-weight heparins injection combined with Shuxuening injection in the treatment of patients with cerebral infarction accompanied with carotid atherosclerosis.Method： 150 patients with acute cerebral infarction accompanied with carotid atherosclerosis were randomly divided into three groups（n=50,each group）：control group and two low-molecular-weight heparins injection groups with a small and a large dosage.The control group was treated with Shuxuening injection 20mL＋physiological saline 250 mL,iv,drip,qd for 21d.The large dosage group was treated with low-molecular-weight heparins injection 5000AXaIU,ih,q12h combined with Shuxuening injection for 14d.The small dosage group was treated with low-molecular-weight heparins injection 5000AXaIU,ih,qd combined with Shuxuening injection for 14d.Result： The neurological deficits scale of stroke was obviously decreased in the large dosage group at 3 months than that in the small dosage group and the control group（P〈0.001）;The area of carotid atherosclerosis was obvious decreased in the three groups after treatment of 3 months（P〈0.01）;The recurring rate of cerebral infarction in the large dosage group was lower than that in the other groups（P〈0.05）.There was no serious bleeding situation during treating of low-molecular-weight heparins injection combined with Shuxuening injection.Conclusion： Large dosage low-molecular-weight heparins injection combined with Shuxuening injection is effective and safe in treating acute cerebral infarction and carotid atherosclerosis,and can decrease recurring rate of cerebral infarction significantly.