CAJ | 학술논문

目的观察磺达肝癸钠治疗高龄急性冠脉综合征(ACS)患者的临床疗效及安全性.方法将84例70岁以上高龄ACS患者数字表法随机分成治疗组和对照组,两组均在常规治疗的基础上,治疗组40例加用磺达肝癸钠2.5 mg皮下注射,每天1次,疗程8d;对照组44例加用低分子肝素钙0.4ml,2次/d(每12小时1次,根椐体质量调整剂量),脐旁皮下注射,疗程8d,观察两组治疗期间的临床疗效,以及4周时心血管事件和治疗期间出血的发生率.结果治疗组与对照组临床疗效差异无统计学意义(95％比91％,P＞0.05)；两组均未发生死亡、再发心肌梗死及恶性心律失常；两组均朱发生大出血,治疗组轻微出血发生率明显低于对照组(7.5％比25％,P＜0.05).结论磺达肝癸钠与低分子肝素钙治疗ACS均有效,但前者轻微出血的发生率较后者明显降低.磺达肝癸钠用于ACS的抗凝治疗不仅能够有效的减少心血管事件,而且大大降低出血风险,无论患者的年龄、性别、肾功能情况和危险分层,尤其对于出血风险较高的高龄患者更安全,值得临床推广.
목적 관찰광체간계납치료고령급성관맥종합정(ACS)환자적림상료효급안전성.방법 장84례70세이상고령ACS환자수자표법수궤분성치료조화대조조,량조균재상규치료적기출상,치료조40례가용광체간계납2.5 mg피하주사,매천1차,료정8d;대조조44례가용저분자간소개0.4ml,2차/d(매12소시1차,근거체질량조정제량),제방피하주사,료정8d,관찰량조치료기간적림상료효,이급4주시심혈관사건화치료기간출혈적발생솔.결과 치료조여대조조림상료효차이무통계학의의(95％비91％,P＞0.05)；량조균미발생사망、재발심기경사급악성심률실상；량조균주발생대출혈,치료조경미출혈발생솔명현저우대조조(7.5％비25％,P＜0.05).결론 광체간계납여저분자간소개치료ACS균유효,단전자경미출혈적발생솔교후자명현강저.광체간계납용우ACS적항응치료불부능구유효적감소심혈관사건,이차대대강저출혈풍험,무론환자적년령、성별、신공능정황화위험분층,우기대우출혈풍험교고적고령환자경안전,치득림상추엄.
Objective To observe the efficacy and safety of liver decanoic sulfonic sodium in the treatment of elderly patients with acute coronary syndrome (ACS).Methods84 ACS patients over 70 years were randomly divided into the treatment and control groups.Two groups were treated on the basis of general,treatment 40 cases of liver of dibutyl sebacate with sodium sulfonated added 2.5 mg subcutaneous injection parumbilical,day 1,course 8 d ; control group 44 cases combined with low molecular weight heparin calcium 0.4 ml,2 times/day 1 time every 12 hours,according to body weight adjusted dose,Parumbilical shot in course of 8 days,observing the clinical effect of two groups during the treatment,as well as 4 weeks and bleeding during the treatment the incidence of cardiovascular events.Results The clinical effects of treatment and control groups was no significant difference (95％ and 91％,P ＞0.05) ; None of the two sets of death,myocardial infarction and recurrent malignant ventricular arrhythmia; none of the two sets of bleeding occurs,treatment of minor bleeding rates were significantly lower than those of control groups (7.5％ and 25％,P ＜ 0.05).Conclusion The study of dibutyl sebacate with sodium heparin and low molecular weight heparin calcium in the treatment of ACS are valid,but the former which significantly reduce the incidence of minor bleeding.Liver decanoic sulfonic sodium for acute coronary syndrome ACS)anticoagulation can not only effectively reduce cardiovascular events,but also significantly reduce bleeding risk,regardless of the patient's age,gender,renal function and risk stratification,especially for bleeding in high risk elderly patients with safe and clinical promotion.