巴曲抗栓酶治疗不稳定型心绞痛的疗效及其对血小板聚集的影响.docVIP

???? 巴曲抗栓酶治疗不稳定型心绞痛的疗效?及其对血小板聚集的影响 ???? ????摘要　目的：探讨巴曲抗栓酶对不稳定型心绞痛(UAP)的临床疗效及其对血小板聚集的影响。方法：60例UAP患者随机分成A组和B组，在抗心绞痛常规疗法基础上，A组加用巴曲抗栓酶，分别于第1、3、5天予10 u、5 u、和5 u，以100 ml生理盐水稀释后静脉滴注1 h；B组加用普通肝素，100 mg加入5%葡萄糖溶液中静脉滴注，每天1次，共5 d。6 d后考核疗效及有关实验室指标。结果：A、B组的临床总有效率分别为86.7%和80.0%。治疗期间A组的硝酸甘油用量和镇痛药使用次数较B组少(分别P＜0.01和0.05)。A组治疗前后的血小板计数、凝血酶原时间(PT)、激活的部分凝血活酶(APTT)均无显著变化，而纤维蛋白原(FIBEN)明显降低；B组的PT、APTT明显延长，FIBEN无降低(P＞0.05)。二磷酸腺苷(ADP)和肾上腺素(NE)对血小板的最大诱聚率，A组从治疗前的(74.3±16.3)%和(87.9±10.6)%降至治疗后的(60.8±18.7)%和(82.5±7.3)%(P＜0.01)；B组治疗前后则无显著性差异(P＞0.05)。结论：巴曲抗栓酶治疗UAP疗效好，能降低FIBEN水平，抑制ADP和NE诱导的血小板聚集，使用方便、安全，值得推广。　　关键词　不稳定型心绞痛　巴曲抗栓酶　肝素　血小板聚集 Clinical effects of treating unstable angina petoriswith batroxobin and it′s effect on platelet aggregation Mai Weiyi　Zeng Qunying　Li Yujie　et al(Cardiovascular department,Internal Medicine,First Affiliated Hospital,Sun Yat-sen University of Medical Sciences,Guangzhou 510080 ) 　　Abstract　Objective:To investigate the clinical effects of treating unstable angina pectoris with batroxobin and it′s effect on platelet aggregation.Method:60 cases were randomly assigned into group A (tested group) and B (control).Besides routine antiangina therapy,patients in group A were given batroxobin 10u,5u and 5u respectively on first,third and fifth day.Batroxobin was diluted in 100 ml of NS,then intravenously dripped for 1 hour.Patients in group B were given 100 mg of regular heparin,diluted in 500 ml of 5% glucose solution,intravenously dripped once daily for five days instead of batroxobin.Result:Total clinical effective rate of group A and B were 86.7% and 80.0%.The consumption of nitroglycerin and times of analgesic required in group A were fewer then that of group B during therapeutic period (P＜0.01 and 0.05 respectively).Numbers of ST segment depressed leads and total depressed mv value were significantly improved after the therapy in both groups (P＜0.01).There were no significant changes in platelet count (PLT),plasma prothrombin time (PT) and activated partial thrombpl