低分子肝素联合阿司匹林治疗动脉源性短暂性脑缺血发作近期疗效观察

Clinical Effects of Combination Therapy of Low-molecular-weight Heparin and Aspirin on Patients with Transient Ischemic Attack of Arterial Originated

关键词:  低分子肝素  阿司匹林  短暂性脑缺血发作

Key words:  low-molecular-weight heparin  aspirin  transient ischemic attack

摘要:

目的 探讨低分子肝素(1ow-molecular-weight heparin，LMWH)联合阿司匹林(aspirin，ASA)治疗动脉源性短暂性脑缺血发作(transient ischemic attack，TIA)患者的疗效。方法 应用ABCD3评分测定186例动脉源性TIA患者的分值，根据分值分为低、中、高危3组，每组再随机分为治疗组和对照组。对照组每天给予ASA 100 mg口服和奥扎格雷160 mg静滴，治疗组在此基础上加LMWH脐周皮下注射。观察1月内TIA控制率和脑梗死的发生率。结果 低危组的治疗组和对照组TIA控制率和脑梗死发生率比较无明显差异。中、高危组的治疗组TIA控制率明显高于对照组；中、高危组的治疗组脑梗死发生率明显小于对照组；治疗组与对照组比较差异有统计学意义。结论 LMWH联合ASA治疗ABCD3中高评分值TIA和脑梗死发生的近期疗效优于单用ASA。

Abstract:

OBJECTIVE To assess effects of combination therapy of low-molecular-weight heparin(LMWH) and aspirin(ASA) in transient ischemic attack(TIA) of arterial originated. METHODS With ABCD3 score, 186 cases of TIA of arterial origin were classified into three risk groups(low, moderate and high). Furthermore, three risk groups were randomized into treatment group and control group separately. The control group were treated with ASA 100 mg once daily and ozagrel 160 mg iv gtt. The treatment group was added with LMWH 0.4 mL twice daily subcutaneous injection, within 10 days. Therapeutic effect was observed with control rate of TIA and incidence of acute ischemic stroke(AIS) within 1 month. RESULTS There were no significant differences in control rate of TIA and incidence of AIS in 1ow risk group. The control rate of TIA in moderate and high risk groups were higher in the treatment group than in control group significantly. Incidence of AIS in moderate and high risk groups was lower in the treatment group than in control group significantly at 1 month. No major hemorhagic complications were observed. CONCLUSION The combination of ASA and LMWH in TIA patients with moderate and high ABCD3 score could be more effective than ASA monotherapy.