中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2010年
10期
628-631
,共4页
王琼康%郭牧%张云强%宋昱
王瓊康%郭牧%張雲彊%宋昱
왕경강%곽목%장운강%송욱
急性冠脉综合征%磺达肝癸钠%低分子肝素%抗凝
急性冠脈綜閤徵%磺達肝癸鈉%低分子肝素%抗凝
급성관맥종합정%광체간계납%저분자간소%항응
Acute coronary syndromes%Fondaparinux%Low molecular weight heparin%Anticoagulation
对比磺达肝癸钠与低分子肝素(LMWH)在治疗急性冠脉综合征(ACS)中的疗效及安全性.方法 选择2009年11月至2010年8月本院确诊的ACS患者105例,按随机原则分为两组,均给予硝酸酯类、β受体阻滞剂、血管紧张素转换酶抑制剂(ACEI)或血管紧张素受体阻滞剂(ARB)、他汀类、氯吡格雷、肠溶阿司匹林等基础药物治疗;在基础治疗上磺达肝癸钠组(50例)每日1次皮下注射磺达肝癸钠2.5 mg,LMWH组(55例)每日2次皮下注射LMWH 0.4 ml,均连用3～8 d.观察两组治疗期间的临床疗效,以及7 d、30 d时心血管事件和治疗期间出血的发生率.结果 磺达肝癸钠组与LMWH组总有效率比较差异无统计学意义(96.0%比92.7%,P＞0.05);7 d、30 d时心血管事件(死亡、急性心肌梗死和再发心肌梗死)的发生率比较差异也无统计学意义(7 d:4.0%比7.3%,30 d:8.0%比10.9%,均P＞0.05);两组均未发生大出血,磺达肝癸钠组轻微出血发生率明显低于LMWH组(2.0%比32.7%,P＜0.01).结论 应用磺达肝癸钠治疗ACS具有不劣于LMWH的疗效,而且有着良好的安全性,不良反应少,值得推广.
對比磺達肝癸鈉與低分子肝素(LMWH)在治療急性冠脈綜閤徵(ACS)中的療效及安全性.方法 選擇2009年11月至2010年8月本院確診的ACS患者105例,按隨機原則分為兩組,均給予硝痠酯類、β受體阻滯劑、血管緊張素轉換酶抑製劑(ACEI)或血管緊張素受體阻滯劑(ARB)、他汀類、氯吡格雷、腸溶阿司匹林等基礎藥物治療;在基礎治療上磺達肝癸鈉組(50例)每日1次皮下註射磺達肝癸鈉2.5 mg,LMWH組(55例)每日2次皮下註射LMWH 0.4 ml,均連用3～8 d.觀察兩組治療期間的臨床療效,以及7 d、30 d時心血管事件和治療期間齣血的髮生率.結果 磺達肝癸鈉組與LMWH組總有效率比較差異無統計學意義(96.0%比92.7%,P＞0.05);7 d、30 d時心血管事件(死亡、急性心肌梗死和再髮心肌梗死)的髮生率比較差異也無統計學意義(7 d:4.0%比7.3%,30 d:8.0%比10.9%,均P＞0.05);兩組均未髮生大齣血,磺達肝癸鈉組輕微齣血髮生率明顯低于LMWH組(2.0%比32.7%,P＜0.01).結論 應用磺達肝癸鈉治療ACS具有不劣于LMWH的療效,而且有著良好的安全性,不良反應少,值得推廣.
대비광체간계납여저분자간소(LMWH)재치료급성관맥종합정(ACS)중적료효급안전성.방법 선택2009년11월지2010년8월본원학진적ACS환자105례,안수궤원칙분위량조,균급여초산지류、β수체조체제、혈관긴장소전환매억제제(ACEI)혹혈관긴장소수체조체제(ARB)、타정류、록필격뢰、장용아사필림등기출약물치료;재기출치료상광체간계납조(50례)매일1차피하주사광체간계납2.5 mg,LMWH조(55례)매일2차피하주사LMWH 0.4 ml,균련용3～8 d.관찰량조치료기간적림상료효,이급7 d、30 d시심혈관사건화치료기간출혈적발생솔.결과 광체간계납조여LMWH조총유효솔비교차이무통계학의의(96.0%비92.7%,P＞0.05);7 d、30 d시심혈관사건(사망、급성심기경사화재발심기경사)적발생솔비교차이야무통계학의의(7 d:4.0%비7.3%,30 d:8.0%비10.9%,균P＞0.05);량조균미발생대출혈,광체간계납조경미출혈발생솔명현저우LMWH조(2.0%비32.7%,P＜0.01).결론 응용광체간계납치료ACS구유불렬우LMWH적료효,이차유착량호적안전성,불량반응소,치득추엄.
Objective To compare the efficacy and safety of fondaparinux with that of low molecular weight heparin (LMWH) in the treatment of acute coronary syndrome (ACS). Methods One hundred and five patients with ACS admitted from November 2009 to August 2010 were randomly divided into two groups. They were all treated with nitrates, β-blockers, angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB), statins, clopidogrel, enteric-coated aspirin and other basic drugs. On the basis of the above treatment, the fondaparinux group patients (n=50) received hypodermic injection of fondaparinux 2.5 mg, once a day, and the LMWH group patients (n=55) received hypodermic injection of LMWH 0.4 ml, twice a day, the therapeutic course being 3- 8 days of both groups. The therapeutic efficacy, the cardiovascular event and bleeding incidences during 7 days and 30 days of the treatment were observed. Results There was no significant difference between the fondaparinux group and LMWH group in the total effective rate (96.0% vs. 92.7%, P＞0.05), also no significant differences were found between the two groups in cardiovascular events (death, acute myocardial infarction and recurrence of myocardial infarction) during 7 days and 30 days (7 days: 4.0% vs. 7.3%, 30 days: 8.0% vs. 10.9%, both P＞0.05). There was no major bleeding incident, and the incidence of minor bleeding in fondaparinux group was obviously lower than that in LMWH group (2.0% vs. 32.7%, P＜0.01). Conclusion The efficacy of fondaparinux in the treatment of ACS is not inferior to that of LMWH, and adverse events during and after its administration were significantly lower than those in LMWH group, so that fondaparinux treatment for ACS is safe and can be highly recommended.
