低分子肝素阿斯匹林合用治疗老年不稳定型心绞痛的临床观察

Clinical observation of the treatment of old-age UAP by using LMWH and aspirin together

目的 :探讨低分子肝素钙与阿斯匹林联合应用对老年人不稳定型心绞痛 (UAP)的疗效及安全性。方法 :选择 6 3例具有典型的临床症状和心电图改变而确诊的老年UAP病人 ,平均年龄 (70± 1.5 )岁。随机分为两组 ,A组 (2 8例 )给予阿斯匹林 0 .1g和抗心绞痛常规治疗 ;B组 (35例 )给予阿斯匹林 0 .1g和抗心绞痛常规治疗加皮下注射低分子肝素钙 (LMWH) 0 .4ml,q12h ,连用 7天。根据两组治疗前后临床症状及心电图变化判定显效、有效或无效。并于用药前后测血常规、血小板、出凝血时间、凝血酶原时间。结果 :A组与B组在改善心绞痛症状及心电图表现方面总有效率分别为 4 3%和 85 %(P <0 .0 1)。两组均未发生心脏事件。B组低分子肝素治疗全部耐受 ,无一例出现出血。结论 :低分子肝素与阿斯匹林合用对控制老年UAP患者心绞痛发作效果肯定 ,未出现出血等不良反应 。

Objective:To explore the effect and safety of using LMWH together with aspirin for old-age UAP.Method:To choose 63 typical old-age UAP patients with an average age of 70±1.5 according to their clinical symptoms and the change of ECG and divide them into 2 groups.Group A (28 patients) were given aspirin(0.1g),and were treated with conventional method,while Group B(35 patients),besides the above treatment,were injected subcutaneously with LMWH 0.4ml,q12h,for 7 days.According to the clinical symptoms and ECG change before and after the treatment,judge whether it is very effective,effective or ineffective.And ,before and after treatment,test BRT,blood platelet,the time of thromebogen,etc.As a result,the general rates of efficieney in Group A and B are 43%and 85%(p<0.01)respectively in the improvement of UAP and ECG.Nothing about heart disease happened in the two groups.In Group B,and what is more,LMWH was proper to everyone and none of them hemorrhaged.Conclusion:When controlling old-age UAP by using LMWH and aspirin together,the result is affirmative.No bad reaction such as hemorrhage happened and it is safe to use.