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| 2010-01-28 |
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Low molecular weight heparin in the treatment of Acute Cerebral Infarction
Of acute cerebral infarction is a threat to people's health, one of the major diseases. If the irreversible ischemic tissue damage occurs before the thrombolytic therapy, so that infarct vessel recanalization can reduce ischemic injury. Low molecular weight heparin can alter blood viscosity and promoting blood flow, increase cell surface charge, thus enhancing the anti-coagulating, anti-thrombotic effect. I Section 3 plus years of regular treatment with low molecular weight heparin plus heparin and non-conventional therapy to control study of 96 cases are reported as follows.
1 Data and methods
1.1 The clinical data from 1998 to 2001 by 96 cases treated in line with the Fourth National Cerebrovascular Disease Academic Council to amend the treatment standards, and cerebral infarction confirmed by CT. Conditions: 72h onset within 65 years of age, blood pressure does not exceed 192/100mmHg, unconscious barriers, without high intracranial pressure, anticoagulant therapy prior to their families account for anticoagulant purposes, pay attention to the matter and possible bleeding problems, and the family agreed to sign only after heparin therapy. We selected 96 cases were divided into treatment group and control group of 46 cases. Treatment group, 38 male and 8 females. Control group, 39 males, 7 females. The average age of two groups: treatment group was 61.3 years, control group 60.7 years of age.
1.2 Methods selected treatment group and control group as a routine treatment, 5% glucose 250ml Garvey cerebral road leads to 0.8% plus 0.5% citicoline infusion day 1, a course of treatment for 14 days. If cerebral edema or symptoms of a heavier person and mannitol infusion, high blood sugar or diabetes plus insulin therapy. With heparin treatment group, subject to conditions, a normal prothrombin time, fibrinogen, higher than normal or no signs of bleeding may use low-molecular weight heparin 0.5U, subcutaneous injection on the 1st 2 times.
1.3 determine the efficacy of (1) cure: consciousness-ching, language fluency, be able to walk independently, the patient limb muscle strength returned to 4 ~ 5. (2) improved: The main signs of significant recovery, limb muscle strength increased more than 2. (3) invalid: no major signs of improvement, no change in muscle strength before and after treatment.
2 Results
Treatment group, 48 cases were cured in 18 cases (37.5%), improved in 28 cases (58.33%), 2 cases (4.17%), cure rate of 96.8% improved. Control group, 48 patients were cured, 4 cases (8.33%), improvement in 27 cases (56.25%), healed in 17 cases (35.43%), cure rate of 64.58% improvement difference between two groups was significant (P <0.05).
3 Discussion
Low molecular weight heparin on blood coagulation in the central part of the process of Xa inhibited, so that blood clotting impeded. Heparin also prevents platelet adhesion, aggregation, lower blood viscosity, it is used for thrombotic disease. Cardiovascular disease in the past for more recent years, low molecular weight heparin in ischemic cerebrovascular disease applications, are increasingly valued by clinicians and Application
Low molecular weight heparin subcutaneous bioavailability of 90%. 3h after injection of up to the peak anticoagulant. The duration of 10h, and therefore more in each 6 ~ 8h after injection, blood platelet, prothrombin time. Low molecular weight heparin has a molecular weight is small, strong antithrombotic effect of high bioavailability, plasma half-life of long, low-impact on platelet characteristics, treatment bleeding occurs during the low rate of [1]. In this group 48 cases were treated by the treatment group improved significantly higher cure, does not appear hemorrhagic infarction. In my opinion, choose a good drug indication, the future quality of life for patients has increased the role can not be ignored. Heparin within the 72h treatment time better effect, generally monitored by 3 ~ 7 days. Low molecular weight heparin anticoagulation is not only anti-thrombosis, but also can decrease blood fat, reduce disease risk factors occurred in the role of [2]. Therefore, low molecular weight heparin in the treatment of ischemic cerebrovascular diseases have a better future.
References
1 Li Xiaoxiang, Li's resistance. Low molecular weight heparin antithrombotic effects. Pharmacy progress, 1994,18 (1) :6-10.
2 Guo, Lin. Low molecular weight heparin in the treatment of acute ischemic stroke. Foreign Medical cerebrovascular disease volumes, 1996,4 (3) :185-186. (Received Date :2003-09-03)
Author: 1050011 Hebei Province, Shijiazhuang Railway Central Hospital; the Second Hospital of Hebei Medical University, |
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