低分子肝素与普通肝素治疗不稳定性心绞痛疗效观察

Low molecular weight heparin versus regular heparin in the treatment of unstable angina

目的 比较低分子肝素与普通肝素治疗不稳定性心绞痛 (UA)的疗效及安全性。方法 采用随机单盲对照方法 ,在一般治疗基础上 ,将UA 6 2例随机分为低分子肝素组 (LMWH组n =30 ) ,给予速避凝 0 .4ml(相当于 410 0IUAXa)H ,每日 2次 ;肝素组 (RH组n =32 ) ,给予肝素 40 0IU·kg- 1 ·d- 1 持续静滴 ,每 8小时监测一次aPTT ,并调整剂量 ,疗程均为 7天。观察治疗前后 :①心电图及心绞痛症状疗效 ;② 2 4h总缺血时间疗效 ;③半年内心绞痛复发率、AMI发生率及死亡率 ;④副作用。结果 两组在心绞痛症状、心电图改善疗效显著 ,治疗后 2 4h总缺血时间明显减少 (P <0 0 0 1) ,两组间无显著差异 ,(P >0 0 5 ) ,半年内心绞痛复发率及AMI发生率LMWH组与RH组比较差异不显著 (P >0 0 5 ) ,但出血副作用轻。结论 低分子肝素治疗UA安全、有效、方便。

Objective: To compare the efficacy and safety of low molecular weight haparin with regular heparin in the treatment of unstable angina. Methods: 62 UA cases who were treated with regular therapy were divided randomly into two groups: group LMWH (n=30) treated with LMWH—Fraxiparine 0.4 ml, H,bid;group RH(n=32) treated with regular heparin 400 IU·kg -1 ·d -1 by intravenous continue. according the aptt to chang the doses. Both groups had been treated for seven days, to investigate ① The relief of the syimpotom of angina, electrocardiogram(ECG)before and after treatement; ② The total of the cardial ischemic during 24 h of the before and after treatment; ③ The recu rrencerates of the angina, AMI and death rates during half a year, ④ The side effection.Results: The efficacy of reliefing angina,improved ECG and redced of the total ischemic times during 24 h were significanty in two groups,and there was no significant diffrence in the formal between them(P>0.05).The recurrence rates of the angina and the AMI and death rates in the patients of group LMWH was not obviously reduced than that group RH during half a year (P>0.05), the side effection in the group LMWH was slight than that in the group RH. Conclusion: The therapy of the LMWH is effect and safty for patients with UA.