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目的观察低分子肝素治疗频发短暂性脑缺血发作(TIA)的近远期疗效。方法63例频发TIA患者随机分为低分子肝素组(治疗组)30例和常规治疗组(对照组)33例。观察两组TIA发作停止时间;治疗前及治疗后7d血小板计数(Plt)、出血时间(BT)、凝血时间(CT)、凝血酶原时间(PT)、纤维蛋白原定量(Fib),出院后3个月、6个月TIA发作次数,住院期间、出院后3个月、6个月进展为脑卒中例数。结果24h内及48h内TIA发作控制率治疗组分别为36.7%、70%,对照组分别为12.1%、33.3%,两组比较有统计学差异(χ2=3.15,P<0.05)。随访3个月、6个月治疗组TIA发生率分别为13.3%、23.3%、脑梗死发生率分别为0、3.0%,对照组TIA发生率分别为27.3%、33.1%、脑梗死发生率分别为12.1%、21.2%,两组比较无统计学差异(P>0.05)。治疗组治疗后Fib明显降低,与治疗前比较用统计学差异P<0.05)。两组治疗前后BT、CT、PT无显著性差异。结论低分子肝素治疗频发短暂性脑缺血发作近期疗效显著、安全。
Objective To observe the short-term and long-term effects of low molecular weight heparin in the treatment of frequent transient ischemic attack (TIA). Methods Sixty-three patients with frequent TIA were randomly divided into low molecular weight heparin group (treatment group), 30 patients and control group (33 patients). The duration of the onset of TIA in both groups was observed. Plt, BT, PT, Fib were measured before and after 7 days of treatment. After discharge, 3 months, 6 months the number of TIA episodes, hospitalization, 3 months after discharge, 6 months progression to stroke cases. Results The control rates of TIA in treatment group and control group were 36.7% and 70% within 24 h and 48 h, respectively, which were 12.1% and 33.3% respectively in the control group (χ2 = 3.15, P <0.05). The incidence of TIA in 6-month treatment group was 13.3% and 23.3% respectively, and the incidence of cerebral infarction was 0 and 3.0% respectively. The incidence of TIA in control group was 27.3% and 33.1% respectively, and the incidence of cerebral infarction was 12.1%, 21.2%, no significant difference between the two groups (P> 0.05). The treatment group Fib significantly reduced after treatment, compared with before treatment with a statistically significant difference P <0.05). Before and after treatment BT, CT, PT no significant difference. Conclusion Low molecular weight heparin treatment of frequent transient ischemic attack in the short term effect is significant and safe.