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目的:观察延长使用低分子肝素治疗高原非ST段抬高型急性冠脉综合征(NSTE-ACS)患者的疗效及安全性。方法:将85例NSTE-ACS患者随机分为常规治疗组(n=42)和延长治疗组(n=43),常规治疗组采用低分子肝素(依诺肝素)皮下注射治疗5～7 d,延长治疗组治疗10～14 d,其余基础治疗相同。观察30 d内心血管事件、出血事件和血小板减少的发生率。结果:常规治疗组30 d内心血管事件的发生率为19%,延长治疗组为5%,两组间有显著差异(P<0.05);常规治疗组30 d内出血事件的发生率为5%,延长治疗组为5%,两组间无显著差异;两组患者中均未观察到血小板减少和APTT延长的发生。结论:延长使用(10～14 d)低分子肝素治疗高原NSTE-ACS可显著降低30 d内心血管事件的发生率,且不增加出血风险和血小板减少事件的发生率。
Objective: To observe the effect and safety of prolonged use of low molecular weight heparin in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS). Methods: Eighty-five patients with NSTE-ACS were randomly divided into conventional treatment group (n = 42) and extended treatment group (n = 43). Conventional treatment group was treated with subcutaneous injection of low molecular weight heparin (enoxaparin) Prolonged treatment group for 10 to 14 days, the rest of the same basic treatment. The incidence of cardiovascular events, bleeding events and thrombocytopenia within 30 days was observed. Results: In the conventional treatment group, the incidence of cardiovascular events was 19% within 30 days and 5% in the extended treatment group, with significant difference between the two groups (P <0.05). In the conventional treatment group, the incidence of bleeding events within 30 days was 5% Prolonged treatment group was 5%, no significant difference between the two groups; no thrombocytopenia and APTT prolongation occurred in both groups. CONCLUSIONS: Prolonged (10-14 d) LMWH treatment of plateau NSTE-ACS significantly reduces the incidence of cardiovascular events within 30 days without increasing the risk of hemorrhage and thrombocytopenia.