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目的探讨不稳定性心绞痛临床治疗效果。方法回顾分析2005年1月至2009年10月60例患者的临床资料。结果本组60例,显效41例,有效16例,无效3例;静息心电图变化:显效者23例,改善者22例,无变化者15例。实验室指标APTT:治疗前52s,治疗后56s;PLT:治疗前162×109/L,治疗后163×109/L。未见全身不良反应,有5例在腹壁注射部位出现瘀斑,无其他部位出血。结论低分子肝素通过抗凝血酶水解,对因子Xa抑制的作用更强,平均分子量4200～6000Da,与普通肝素相比,与血浆蛋白和内皮细胞结合减少,清除呈剂量依赖性并且半衰期长,1～2次/d皮下注射就可以获得持续的抗凝作用;另外无需在实验室监测活性,对血小板的刺激作用不如普通肝素,较少发生肝素诱导的血小板减少性紫癜。总之LMWH在UA的治疗中效果满意,值得临床应用。
Objective To investigate the clinical effect of unstable angina pectoris. Methods The clinical data of 60 patients from January 2005 to October 2009 were retrospectively analyzed. Results The group of 60 patients, markedly effective in 41 cases, effective in 16 cases, 3 cases of ineffective; resting ECG changes: 23 cases were markedly improved in 22 cases, no change in 15 cases. Laboratory indicators APTT: 52s before treatment, 56s after treatment; PLT: 162 × 109 / L before treatment and 163 × 109 / L after treatment. No systemic adverse reactions, 5 cases of ecchymosis in the abdominal injection site, no other parts of the bleeding. Conclusion Low molecular weight heparin hydrolyzed by antithrombin has a stronger effect on the inhibition of factor Xa with an average molecular weight of 4200-6000 Da. Compared with unfractionated heparin, low molecular weight heparin has less binding to plasma proteins and endothelial cells, and has a dose-dependent and long- 1 ~ 2 times / d subcutaneous injection can be sustained anticoagulant effect; the other without monitoring activity in the laboratory, the stimulating effect on platelets as unfractionated heparin, less incidence of heparin-induced thrombocytopenic purpura. In conclusion LMWH in the treatment of UA satisfactory results, it is worth clinical application.