低分子肝素对冠状动脉支架植入术后近期疗效的影响

The Short-term Therapeutic Effect of Subcutaneous Low Molecular Weight Heparin on Heart Events After Successful Intracoronary Stent Implantation

目的:观察冠状动脉支架术后应用低分子肝素(LMWH)对近期心脏事件、心肌缺血、出血风险、血栓形成的影响。方法:167例行支架术的冠心病患者,随机分为对照组(83例)、LMWH组(84例)。两组:术前术后常规应用阿司匹林和抵克力得;LMWH组:加用LMWH 0.4 ml,皮下注射,1次/12小时,连续10天。结果:对照组有2例出现亚急性血栓,而LMWH组没有发生(P>0.1)。LMWH组心绞痛发作次数及心肌缺血总负荷均较对照组少(P<0.01)。结论:支架术后应用LMWH可降低心脏事件发生,改善心肌血供,出血并发症少,方便且安全。

Objective: To observe the effects of low molecular weight heparin(LMWH) on reducing Heart event and myocardial ischemia, and bleeding complications of LMWH in patients with intracoronary stent implantation. Methods: 167 with coronary artery disease underwent intracoronary stent implantion were randomly divided into two groups: LMWH group (n =83), control group (n =84), Control group was given aspirin and ticlopidine as usual, and LMWH× group was given additional LMWH (0. 4 ml 1 12 h × 10 d). Results: Intracoronary thrombosis after stent implantation occurred in two cases in control group. However this didn' t occur in LMWH group ( P >0.1) . LMWH group has lower chance of both angina and total ischemia load than control group (P<0.01). Conclusion: Subcutaneous LMWH after intracoronary stent implantation can reduce the chance of Heart enent and myocardial ischemia, without serious bleeding complication. The routine use of LMWH shows more convenience and safity.