低分子肝素联合氟桂利嗪对频发性TIA患者脑梗死的预防效应

The effects of low molecular weight heparin combined with flunarizine on the prevention of cerebral infarction to patients with the frequency transient ischemic attack

目的:评估频发性短暂脑缺血发作(TIA)患者联合应用低分子肝素与氟桂利嗪,对预防发生脑梗死的临床价值。方法:选取132例频发性TIA患者,按治疗方案不同分为:对照组65例,予以低分子肝素治疗;研究组67例,予以低分子肝素联合氟桂利嗪治疗。两组均予以抗血小板、调脂等基础治疗,疗程均为2周。比较两组患者的血液流变学指标、凝血系统指标的差异。随访3月,比较两组TIA复发率和脑梗死发生率的差异及各种不良反应发生率的差异。结果:研究组总有效率、显效率明显高于对照组(P<0.05),两组治疗后全血黏度(低切)、全血黏度(高切)、血浆黏度、凝血酶原时间(PT)、凝血酶原时间国际标准化比值(INR)、纤维蛋白原含量较治疗前明显改善(P<0.05),治疗后研究组较对照组改善更明显(P<0.05)。研究组的TIA复发率和脑梗死发生率低于对照组(P<0.05)。研究组各种不良反应较发生率与对照组比较无统计学差异(P>0.05)。结论:低分子肝素与氟桂利嗪联合应用能显著降低频发性TIA发作频率并减少脑梗死发生几率。

Ob je c t iv e： To evaluate th e clinical effects of low mo lecular w eigh t h ep arin （L MWH） combined with flunarizine on the prevention of cerebral infarction （Cl） to patients with the frequency transient ischemic attack （TIA）. Methods： A to ta l of 132 p a t ien ts wi th th e frequency TIA were chosen and divided into two g ro u p s , control group （65 cases, application with LMWH） and research group （67 cases, application with LMWH combined with flunarizine） , based on distinct chemotherapies. All patients were received the basic therapy of anti-platelet and lipid regulation. The course of two groups^ patients was two weeks. The indexes of hemorheology and coagulation sys-tem were detected and compared between two groups. Follow-up three months, the recurrence rate of TIA and the occurrence of Cl were recorded and compared between two groups. The occurrences of all kinds of adverse reaction were compared between two groups. Results： C om p ared to co n tro l g ro u p , th e ra te s of overall re sp o n se （O R ） and partial response （PR） were higher （P〈0 . 0 5 ） . T h e p o s t- th e ra p y indexes of whole blood visco sity （ low c u t） , whole blood viscosity （high shear） , plasma viscosity, PT, INR, fibrinogen in two groups were lower significantly than the pre-therapy （P〈0 . 05） ,but th e above p o s t- th e ra p y indexes in re se a rch g ro u p were lower th a n th o se in co n tro l gro up （P 〈0. 05）. The recur rence rate of TIA and the occurrence of Cl in research group were lower than those in control group （P 〈0. 05） . The o ccurrences of all k inds of ad v erse re ac tio n were no d iffe ren t b etwe en two g ro u p s. Con c lu -sion： The combination of LMWH and flunar izine can decrease the frequency of TIA and the occurrence of CI.