低分子肝素及普通肝素治疗不稳定型心绞痛临床疗效观察.docVIP

低分子肝素及普通肝素治疗不稳定型心绞痛临床疗效观察【摘要】 目的 探讨低分子肝素与普通肝素治疗不稳定型心绞痛的近期疗效。方法 将89例不稳定心绞痛患者随机分为低分子肝素组（46例，51.69%）和普通肝素组（43例，48.31%），观察两组患者心绞痛发作次数、心电图的变化、急性心肌梗死、急性血管再通术和院内死亡发生率。结果 与普通肝素组相比，低分子肝素组患者的心绞痛发作次数、心电图缺血、急性血管再通术的发生率明显降低，差异有统计学意义 (P 0.05)，两组均无严重出血。结论 低分子肝素治疗不稳定型心绞痛疗效确切和安全。? 【关键词】低分子肝素; 普通肝素; 不稳定型心绞痛 ? ? Short-term efficacy observation of nadroparin calcium in patients with unstable angina AI Min，WANG Xuan-lin. Department of Emergency，the Second Peoples Hospital of Jiaozuo City, Henan Province 454001，China ? 【Abstract】 Objective To investigate the therapeutic efficacy of nadroparin calcium in patients with unstable angina. Methods 89 patients with unstable angina were randomized into 2groups, nadroparin calcium group and control (heparin therapy) group. We observed the frequency of angina onset ,ischemic changes in ECG ,the incidences of myocardial infarction ,emergent revascularization ,and in-hospital mortality respectively after nadroparin calcium or Heparin therapy ,and the outcomes were compared . Results The frequency of angina onset was decreased and myocardial ischemia was improved in nadroparin calcium group. There was a statistically significant difference (P0.05) comparing with control . There was no severe hemorrhagic complication in two groups. Conclusion The efficacy and safety of Nadroparin calcium therapy in patients with unstable angina was proved.? 【Key words】Nadroparin calcium; Heparin ; Unstable angina pectoris 不稳定型心绞痛(unstable angina pectoris,UAP) 易发生心肌梗死和心源性猝死。抗凝治疗及如何应用既安全又有效的抗凝药物是临床医生一直关注的问题。与43例普通肝素组患者相比，本院应用低分子肝素治疗46例不稳定型心绞痛患者取得较好疗效,现报告如下。? 1 资料与方法? 1.1 临床资料 选择2006年2月至2008年2月住院的89例不稳定型心绞痛患者。其中，男61例（68.54%）, 女28例（31.46%）, 年龄35～76岁,平均（56.34±9.48）岁。入选病例均符合1979 年WHO 制订的《冠心病诊断标准》, 并排除患者有持续性心电图ST 段抬高、有抗凝禁忌证,计划在24 h 进行血管再通手术的患者。患者住院时间15～29 d，平均（21.2±5.5）d。以上患者被随机分为低分子肝素组46例和普通肝素组43例，两组患者临床特征无显著差异，具有可比性。? 1.2 研究方法 89例不稳定型心绞痛患者入院后全部接受负荷量阿司匹林300 mg，继之100 mg,1次/d,β受体阻滞剂、血管紧张素转化酶抑制剂(ACEI)和静脉硝酸酯类治疗。对46例患者应用低分子肝素治疗（治疗组）,每12 h腹部皮下注