普通肝素为主联合治疗急性脑梗死优化方案临床研究

Study on the optimization treatment scheme for acute cerebral infarction by heparin unites

目的探讨以普通肝素微量持续静脉泵入为主联合其他多种治疗方法治疗急性脑梗死的优化方案。方法回顾性分析2007至2009年间住院的脑梗死病例,严格按照统一的筛选标准,从中选出年龄、性别、入院神经功能缺损评分、既往史、梗死类型相匹配的患者352例,分为4组:A组:普通肝素联合奥扎格雷钠治疗;B组:普通肝素联合奥扎格雷钠和灯盏花素治疗;C组:普通肝素联合灯盏花素治疗;D组:奥扎格雷钠联合灯盏花素治疗。分别观察4组患者神经功能缺损评分的改善率、总体疗效和不良事件。结果改善率A组与B组均高于C组与D组,且C组又高于D组,差异有统计学意义(P<0.05);总有效率比较,A组与B组均优于C组与D组,差异有统计学意义(P<0.05),而A组与B组,C组与D组之间差异无统计学意义(P>0.05)。不良事件发生率4组差异无统计学意义(P>0.05)。结论普通肝素在急性脑梗死治疗中起主要作用,其联合奥扎格雷钠治疗的方案是最优化的,其安全性也是比较好的。

Objective To explore the optimization scheme of treating the patients with cerebral infarction by continuing administration of heparin through microdosis venous pump combined with different therapies.Methods The data of the patients admitted from 2007 to 2009 were retrospectively analyzed.The patients were strictly selected according to the uniform criteria,including age,gender,admission neurological deficit scores,past history of infarction.The 325 patients were randomly divided into four groups：group A（ordinary heparin ＋ ozagrel）;group B（ordinary heparin＋ breviscapine＋ozagrel）;group C（ordinary heparin＋breviscapine）;group D（ozagrel＋breviscapine）.The patients＇ nerve function damage degree,the improvement rate,the therapeutic outcome,the incidence of bad event were observed in the four groups.Results The improvement rates in group A and group B were significantly higher than those of group C and group D（P〈0.05）,and which in group C was obviously higher than that of group D（P〈0.05）.The total effective rates in group A and group B were significantly higher than those of group C and group D（P〈0.05）,however,there was no significant difference between group A and group B,and between group C and group D（P〉0.05）.There were no significant differences in the incidence of bad event among the four groups（P〉0.05）.Conclusion The ordinary heparin sodium palys an important role in the treatment of acute cerebral infarction,and the therapeutic scheme of ordinary heparin combined with ozagrel is the most optimal,with good safety.