论文部分内容阅读
目的：比较低分子肝素（LMWH）、普通肝素（H）与阿斯匹林单独及联合治疗不稳定型心绞痛（UAP）病人的疗效。方法：UAP患者156例，随机分为1）阿斯匹林（ASP）组，2）阿斯匹林加普通肝素（ASP＋H）组，3）阿斯匹林加低分子肝素（ASP＋LMWH）组。疗程7天并随访观察3－6个月。结果：ASP＋LMWH组心绞痛缓解率显著高于ASP组（91．8％vs58．2％，P＜0．001），与ASP＋H组（80．8％）比较无显著差异性（P＞0．05）。随访观察期间，ASP＋LMWH组心绞痛复发率显著低于ASP组和ASP＋H组（12．0％vs40．6％、40．5％）。ASP组共有7例发生急性心肌梗死，6例猝死，ASP＋H组共有2例发生出血倾向。三组药物治疗前后部分凝血酶原时间，凝血时间无明显变化（P＞0．05）。结论：阿斯匹林加低分子肝素较单用阿斯匹林或加用普通肝素治疗不稳定型心绞痛疗效更好，更安全。
Objective: To compare the efficacy of low molecular weight heparin (LMWH), unfractionated heparin (H) and aspirin in the treatment of patients with unstable angina (UAP) alone and in combination. Methods: One hundred and sixty-five patients with UAP were randomly divided into 1 aspirin (ASP) group, 2 aspirin plus normal heparin (ASP + H) group and 3 aspirin plus low molecular weight heparin (ASP + LMWH) group. The course of 7 days and follow-up observation of 3-6 months. Results: The rate of angina pectoris in ASP + LMWH group was significantly higher than that in ASP group (91.8% vs58.2%, P <0.001), but not significantly different from that in ASP + H group (80.8%) (P> 0.05) . During the follow-up period, the recurrence rate of angina in ASP + LMWH group was significantly lower than that in ASP group and ASP + H group (12.0% vs 40.6%, 40.5%). In ASP group, there were 7 cases of acute myocardial infarction, 6 cases of sudden death, a total of 2 cases of ASP + H group bleeding tendency. The prothrombin time and clotting time had no significant changes before and after the three groups of drugs (P> 0.05). Conclusion: Aspirin plus LMWH is more effective and safer than aspirin alone or UFH for unstable angina pectoris.