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| TIA short-term effect of low molecular weight heparin in the treatment of clinical observation of |
| 2010-01-28 |
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TIA short-term effect of low molecular weight heparin in the treatment of clinical observation of
Key words low molecular weight heparin
【Abstract】 Objective To study the low molecular weight heparin on transient ischemic attack (TIA) of the anticoagulant therapeutic value. Screening patients with TIA admitted to our hospital (January 2004 to 10 months) 50 patients were divided into treatment group (30 cases, application of low molecular weight heparin) and control group (20 cases, oral enteric-coated aspirin). Two groups of patients had infusion Xuesaitong injection. Results of curative effects on the difference between the two groups was significant (chi-square test, P <0.05), the treatment group than the control group. In the brain, gastrointestinal tract, no difference in bleeding gums; in local bleeding in the skin, the treatment group was higher than that, but does not affect the clinical efficacy. Conclusions The TIA patients with a low molecular weight heparin anticoagulant therapy are effective and safe. Methods
Key words low molecular weight heparin in transient ischemic attack
Transient ischemic attack (transient ischemic attack, TIA) incidence rate is high, according to national statistics, men and 54.2/10 million people, women 16.8/10 million people [1], and increased with age, TIA incidence rate increases above 65 years of age increased significantly. Although the symptoms of TIA is not heavy, but the prognosis worrying. It was reported [2], TIA patients with 1 / 3 of stroke occurs, 1 / 3 there are always new attacks, of course, some patients within a period of time to stop attacks on their own; and the onset of 2 to 4, respectively, about 5 % ~ 10% of patients die of cardiovascular disease. In view of these circumstances is particularly important to the prevention and treatment of TIA, and I Division of the TIA patients with a trial of anticoagulant therapy, or subcutaneous low molecular weight heparin, the onset of TIA is designed to discourage and prevent the occurrence of cerebral infarction, and its therapeutic effect observed study, while the safety of this therapy to conduct a clinical observation.
1 Data and methods
1.1 General information from the TIA patients admitted to our hospital (January 2004 to 10 months) who were screened to meet the following conditions: the age of 75 years of age; men and women not limited to; carotid artery or vertebral-basilar arterial system TIA not limited to; systolic blood pressure " 23.9kPa (180mmHg), diastolic blood pressure <16.8kPa (120mmHg); no blood system diseases; no bleeding tendency; without serious liver, kidney, heart and lung dysfunction; clinical presentation consistent with the Fourth National Cerebrovascular Disease in 1995, developed by the Conference of the TIA diagnostic criteria, admission within 10 days prior to onset of two or more times, each patient were carried out brain CT or MRI examination, except for large focal cerebral infarction or cerebral hemorrhage. Selected 50 patients, male 31 cases, 19 females, aged 38 to 75 years old, with an average age of 54. 30 cases were randomly divided into treatment group and control group, 20 cases between the two groups of gender, age and disease were no significant differences in the degree, comparable.
1.2 treatments groups: low molecular weight heparin calcium injection (trade name Bo Pu blue, red by Tianjin Pharmaceutical Co., Ltd. production, each 0.4ml), 4100AXaIU, 1 time / 12h, abdominal subcutaneous paraumbilical 2cm, used in conjunction 10 control group: enteric-coated aspirin tablets 100mg, 1 times / d, orally. In both groups the same time, 0.9% saline infusion plus 200ml Xuesaitong injection 600mg, Day 1, treatment for 10 days.
1.3 Evaluation of the main observation of TIA to stop attacks, continued to attack, the number of cases of cerebral infarction and death. Adverse reactions were observed, namely, security, the main observation of whether there is cerebral hemorrhage, gastrointestinal bleeding and mucocutaneous bleeding. 1.4 Statistical Methods Chi-square test.
2 Results
2.1 Clinical Evaluation of the results of the two groups in Table 1.
Table 1 Clinical Observation (omitted)
TIA onset cases of cessation of the treatment group were obviously more than the control group, continued to attack and the number of cases of cerebral infarction occurred significantly less than the control group by chi-square test was significant difference (P <0.05). There were no deaths in
2.2 The safety and feasibility of treating 30 cases in the treatment group, no case of cerebral hemorrhage, gastrointestinal bleeding and bleeding gums, there are six cases of localized injection of Bo Marina Green and the site of infusion and blood appeared subcutaneous ecchymosis; the control group 20 cases, the brain, gastrointestinal tract, gums and partial skin were not found in blood. There was a significant difference between the two groups, but do not affect them in clinical treatment, it is confirmed that low molecular weight heparin on the frequency of treatment of TIA are not only effective but also feasible.
3 Discussion
On the TIA to treatment, more generally accepted view now is to try to complete the prevention of stroke occurrence. Treatment methods are: anticoagulant, anti-platelet aggregation, and sometimes need to carotid endarterectomy [3]. In this study Recurrent TIA patients had anticoagulant treatment, results showed that the clinical low molecular weight heparin anticoagulant treatment is effective and superior to aspirin, and its cerebral hemorrhage, gastrointestinal bleeding risk is small, infusion, local skin puncture There may be bleeding, but does not affect the clinical treatment. Low molecular weight heparin is a heparin by chemical or enzymatic degradation after the derivatives, the average molecular weight of 4000 ~ 5000. With the lower molecular weight, low molecular weight heparin in the body and anti-thrombin, plasma proteins, platelets, vascular endothelium, binding compared with unfractionated heparin big difference [4]; low molecular weight heparin compared with unfractionated heparin antithrombotic effect of Well, bleeding the role of small, high bioavailability, drug delivery convenience [5]; versus unfractionated heparin, anti-Xa molecular role of the affected, can give full play to the role of anti-thrombosis, but significantly reduced the risk of bleeding [6]; used alone in the treatment of low molecular weight heparin before and after the routine blood test, platelets, blood coagulation indicators had no effect. In fact, this study for the TIA of the secondary and tertiary prevention to provide a more effective method. In addition, long-term efficacy study in this group is currently being observed among the right carotid artery and vertebral-basilar artery TIA treatment of different systems have not yet done further to statistics, to be further improved in the future. In short, the control effect of TIA will occur between the cerebral infarction, therefore, can be said that effective treatment of TIA than in the treatment of cerebral infarction but also critical and important, this research shows that low molecular weight heparin anticoagulation for TIA effective treatment , safe, feasible for the fellow in the clinical treatment of reference.
References
1, Wang Xin-de. Neurology. Beijing: People's Medical Publishing House, 2001,195.
2 Houxi Germany. Neurology, 3rd ed. Beijing: People's Health Publishing House, 1995,113.
3 Han Xiang, Dong Qiang. Low molecular weight heparin in the adoption of ischemic cerebrovascular disease. Foreign medical cerebrovascular diseases volumes, 2000,8 (6): 354.
4 Li Xiaoxiang, Li-resistant 3. Antithrombotic effect of low molecular weight heparin. Pharmacy progress, 1993,28:646.
5 SHA Rui-Juan. Low molecular weight heparin in the treatment of acute cerebral infarction with clinical and laboratory observation. Brain and Nervous Diseases, 1999,7 (2): 908.
6 Lide Ping, Tan Heng Chew, Li Jian, et al. Transient ischemic attack processing. Cerebrovascular diseases of foreign medical volumes, 2000,8 (4): 206. |
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