Objective: Acute pulmonary thromboembolism (PTE) is a serious high mortality pulmonary vascular disease whose effective treatment decreases morbidity and mortality. To determine if low-molecular-weight-heparin (LMWH) ...Objective: Acute pulmonary thromboembolism (PTE) is a serious high mortality pulmonary vascular disease whose effective treatment decreases morbidity and mortality. To determine if low-molecular-weight-heparin (LMWH) is clinically as efficient and safe as unfractionated heparin (UH) in patients with diagnosis of acute non-massive PTE, our study compares the efficacy, adverse effects and costs of LMWH and UH. Methods: One hundred and fourteen patients with non-massive acute PTE were randomly divided into LMWH (nadroparin calcium) and UH groups. Oxygenation index, D-dimer, fibrinogen (FG), lung ventilation/perfusion (V/Q) scan and computed tomography pulmonary angiography (CTPA) were observed before anticoagula-tion and on day 14 after anticoagulation. Results: In both groups, the ABG (arterial blood gas) analysis showed PaO2 and PaCO2 were elevated, P(A-a)O2 was decreased and oxygenation index (PaO2/FIO2) was elevated, D-dimer and fibrinogen were decreased, lung V/Q and CTPA showed embolized segments reduced (P<0.05). Hemorrhage and thrombocytopenia occurred in 3.5% of the LMWH group. Hemorrhage occurred in 5.3% and thrombocytopenia occurred in 7.0% of the UH group. The average cost in the LMWH group was RMB 1218.60 Yuan and RMB 1541.40 Yuan in the UH group. Conclusion: LMWH and UH are equally effective for treatment of non-massive acute PTE, but LMWH may have a lower prevalence of complications and is less expen-sive.展开更多
目的 研究脑血管病患者急性期 ( 10 d内 )及亚急性期 ( 4周内 )血浆低分子量肝素 ( L MWH)浓度 ,了解 L MWH样物质水平的自然变化趋势 ,并观察 L MMH治疗干预后体内 L MWH血浓度的变化以及出血副反应与浓度之间的关系。方法 应用发色...目的 研究脑血管病患者急性期 ( 10 d内 )及亚急性期 ( 4周内 )血浆低分子量肝素 ( L MWH)浓度 ,了解 L MWH样物质水平的自然变化趋势 ,并观察 L MMH治疗干预后体内 L MWH血浓度的变化以及出血副反应与浓度之间的关系。方法 应用发色底物法抗 FXa测定法对 84例急性脑血管病患者的血浆 L MWH浓度进行动态观察。结果 脑梗死患者与脑出血患者血浆 L MWH浓度在 0 .3～ 0 .4之间 ,相比无显著性差异 ;应用 L MWH治疗的脑梗死患者血浆 L MWH浓度高于非治疗组 ,且有显著差异性 ;血浆 L MWH浓度与出血副反应有一定的相关性。结论 监测血浆 L MWH浓度有益于防止出血副反应 ,为个体化给药提供了基础。展开更多
文摘Objective: Acute pulmonary thromboembolism (PTE) is a serious high mortality pulmonary vascular disease whose effective treatment decreases morbidity and mortality. To determine if low-molecular-weight-heparin (LMWH) is clinically as efficient and safe as unfractionated heparin (UH) in patients with diagnosis of acute non-massive PTE, our study compares the efficacy, adverse effects and costs of LMWH and UH. Methods: One hundred and fourteen patients with non-massive acute PTE were randomly divided into LMWH (nadroparin calcium) and UH groups. Oxygenation index, D-dimer, fibrinogen (FG), lung ventilation/perfusion (V/Q) scan and computed tomography pulmonary angiography (CTPA) were observed before anticoagula-tion and on day 14 after anticoagulation. Results: In both groups, the ABG (arterial blood gas) analysis showed PaO2 and PaCO2 were elevated, P(A-a)O2 was decreased and oxygenation index (PaO2/FIO2) was elevated, D-dimer and fibrinogen were decreased, lung V/Q and CTPA showed embolized segments reduced (P<0.05). Hemorrhage and thrombocytopenia occurred in 3.5% of the LMWH group. Hemorrhage occurred in 5.3% and thrombocytopenia occurred in 7.0% of the UH group. The average cost in the LMWH group was RMB 1218.60 Yuan and RMB 1541.40 Yuan in the UH group. Conclusion: LMWH and UH are equally effective for treatment of non-massive acute PTE, but LMWH may have a lower prevalence of complications and is less expen-sive.
文摘目的 研究脑血管病患者急性期 ( 10 d内 )及亚急性期 ( 4周内 )血浆低分子量肝素 ( L MWH)浓度 ,了解 L MWH样物质水平的自然变化趋势 ,并观察 L MMH治疗干预后体内 L MWH血浓度的变化以及出血副反应与浓度之间的关系。方法 应用发色底物法抗 FXa测定法对 84例急性脑血管病患者的血浆 L MWH浓度进行动态观察。结果 脑梗死患者与脑出血患者血浆 L MWH浓度在 0 .3～ 0 .4之间 ,相比无显著性差异 ;应用 L MWH治疗的脑梗死患者血浆 L MWH浓度高于非治疗组 ,且有显著差异性 ;血浆 L MWH浓度与出血副反应有一定的相关性。结论 监测血浆 L MWH浓度有益于防止出血副反应 ,为个体化给药提供了基础。
