低分子量肝素及灯盏细辛合用治疗急性脑梗死.docVIP

低分子量肝素及灯盏细辛合用治疗急性脑梗死 　［摘要］ 目的 探讨低分子量肝素与灯盏细辛合用治疗急性脑梗死的临床疗效。方法 将120例急性脑梗死病人随机分成低分子量肝素组（40例，只用低分子量肝素），灯盏细辛组（40例，单用灯盏细辛）及两药合用组（40例）。低分子量肝素的用法为0.4 ml脐周皮下注射，每12 h 1次；灯盏细辛的用法为30 ml加入到5%葡萄糖氯化钠溶液或0.9%氯化钠溶液250 ml中静脉滴注，每日1次。3组均治疗14日。治疗前后分别进行神经功能缺损评分，检查血常规、肝功能、肾功能、凝血功能。结果 两药合用组显效率73%，有效率90%，均显著高于低分子量肝素组和灯盏细辛组（Plt;0.05和Plt;0.01），且未发现有严重的肝、肾功能损害及出血等不良反应。结论 低分子量肝素与灯盏细辛合用治疗急性脑梗死安全有效，疗效优于单用其中一种药物。 　　［关键词］ 低分子量肝素；灯盏细辛；脑梗死；治疗效果；不良反应 　　Effects of enoxaparin combined with dengzhanxixin on the treatment of acute cerebral infarction 　　［Abstract］ Objective To evaluate the clinical efficacy of enoxaparin combined with dengzhanxixin on the treatment of acute cerebral infarction.Methods One hundred and twenty patients were randomly divided into three groups:forty patients were treated only by 0.4 ml enoxaparin，twice daily subcutaneously;forty patients were treated by only 30 ml dengzhanxixin，once daily by intravenous drip;forty patients were treated by enoxaparin and dengzhanxixin.Three groups were treated for 14 days.Impaired neurological function score，routine，liver and kidney function，blood coagulation were examined before and after treatment.Results Significant effective rate and effective rate were 73% and 90% respectively in those patients treated with enoxaparin combined with dengzhanxixin，significantly higher than those in the other two groups （ Plt;0.05 or Plt;0.01 ）.No severe adverse reactions after treatment were found.Conclusion Enoxaparin combined with dengzhanxixin is an effective and safe method of treating acute cerebral infarction. 　　［Key words］ enoxaparin；dengzhanxixin；cerebral infarction；treatment outcome；adverse reaction 　　低分子量肝素是一种抗凝药，灯盏细辛为一中药制剂，有抗凝、溶血栓的作用。为探讨两药联用的临床疗效，我们将120例急性脑梗死病人随机分成灯盏细辛组、低分子量肝素组和低分子量肝素与灯盏细辛合用组，并比较3组的临床疗效、凝血功能的变化及不良反应。 　　1 资料与方法 　　1.1 一般资料 　　1.1.1 入选标准 120例入选病人为我院内科2000年1月～2006年2月的住院病人，符合1995年全国第四届脑血管病学术会议制定的缺血性脑血管病诊断标准［1］，且经头颅CT或磁共振证实为动脉血栓性脑梗死。120例均为首次发病，病程48 h以内。本次治疗前未行溶栓、抗凝及血液稀释等治疗，并排除以下情况：（1）出血性脑梗死者；（2）有出血倾向者或凝血功能差者；（3）有严重的心、肝、肾、肺等疾病者。 　　1.1