大剂量低分子肝素治疗进展性重症脑梗死的临床研究

Clinical study on large dose low molecular weight heparin for treatment of progressing severe cerebral infarction

目的 :观察大剂量低分子肝素治疗进展性重症脑梗死的疗效和安全性。方法 :6 4例发病在 6～ 4 8h内的进展性重症脑梗死患者随机分为治疗组 (34例 )和对照组 (30例 )。均给予低分子右旋糖酐 5 0 0ml,复方丹参 2 0ml。治疗组加用低分子肝素每 12小时 0 .6ml,连续 14d。治疗前后检测血小板 ,凝血和纤溶系统指标。结果 :治疗组疗效明显高于对照组 ,且能延长部分凝血活酶时间 (APTT) ,降低D 二聚体 (D Dimer) ,提高组织型纤溶酶原激活物浓度。结论 :低分子肝素治疗进展性重症脑梗死有肯定的疗效 ,可降低死亡率 ,改善预后 ,且方法简便 。

SUMMARY Objective:To study the effect and safety of high dose low molecular weight heparin (LMWH) in treatment of progressing severe cerebral infarction.Methods: 64 cases with progressing severe cerebral infarction within 6-48 hours of onset,were randomly divided into treated group and controlled group. Two groups were treated with dextran 40 (500 ml) and salviamiltiorrhiza (20 ml). LMWH (0.6 ml) was addeed to the treated gronp twice daily for 14 days. Indexes of platelet, blood coagulation and fibrillolytic system were examined before and after treatment.Results:Effective rate was significantly higher in the LMWH treated group than in the control group. Active partial thromboplastin time (APTT) was prolonged, D Dimer was reduced. Tissue type plasminogen activator(t PA)was increased ( P ≤0.01).Conclusion: These findings suggest that LMWH has a definite therapeutic efficacy for progressing severe cerebral infarction and that it can reduce death rate and promote prognosis It is a safe and simple therapeutic method.