那屈肝素钙治疗急性脑梗死的前瞻性对照研究

The prospective control study of nadroparin calcium in treatment of acute cerebral infarction

目的 :评价那屈肝素钙治疗急性脑梗死的疗效和安全性。方法 :急性脑梗死 2 0 4例 ,用“add on”法随机分为 2组 ,那屈肝素钙组 10 2例予右旋糖酐 4 0 ,50 0mL ,iv ,gtt ,qd ;那屈肝素钙 4 10 0IUAXa ,sc ,bid ,一个疗程 10d。对照组 10 2例仅用右旋糖酐 4 0。结果 :那屈肝素钙组的总有效率为83.3% ,对照组为 70 .6 % ;起病后在 2 4h内开始治疗的有效率为 94 % ,对照组为 76 % ,差异均有显著意义 (P <0 .0 5)。起病后在 2 4～ 4 8h和 >2～ 7d开始治疗的有效率为 81% ,57% ,对照组 70 % ,58% ,差异均无显著意义 (P >0 .0 5)。未发现出血倾向。结论 :早期使用那屈肝素钙治疗急性脑梗死是有效的 ,安全的。

AIM: To evaluate the safety and effect of nadroparin calcium in the treatment of acute cerebral infarction. METHODS: Two hundred and four patients with cerebral infarction were randomly divided into 2 groups. One hundred and two patients of group(1) treated with dextran 40 500 mL, iv,ggt,qd plus nadroparin calcium (Fraxiparine) 4100 IU AXa, sc, bid for 10 d. The other 102 patients of group(2) were as control. They treated with dextran 40 only. RESULTS: The total improving rate(83.3%) of cerebral infarction treated with nadroparin calcium is significantly greater than that of control(70.6%), P <0.05. Meantimes, the improving rate(94%) of cerebral infarction in patients treated with nadroparin calcium within 24 h of onset was significantly greater than that of control(76%), P <0.05. The improving rate(81%,58%) of cerebral infarction in patients treated with nadroparin calcium within 24 to 48 h of onset was also greater than that of control (70%).But there are no statistical difference, P >0.05. There are no statistical deference between both groups after 48 h of onset. The plasma concentration of nadroparin calcium was monitored. No hemorrhage tendency was found by follow up of KPTT, number of platelet and head CT scan. CONCLUSION: For patients with acute cerebral infarction, nadroparin calcium was effective and safe in improving outcomes, and the earlier treatment the more effective.