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目的:评价低分子肝素(LMWH)治疗急性缺血性中风的疗效和安全性.方法:入选病例均用低分子右旋糖苷作基础治疗,治疗组加用LMWH.治疗组:3例进展型短暂脑缺血发作(TIA)及31例发病48h内脑梗死,LMWH4100anti-XaIU,bid,腹壁sc,连续10d.对照组:31例脑梗死.采用中风评分法在用药后1mo进行总评价.用发光底物法测定LMWH浓度.结果:3例TIA症状很快缓解.治疗组的总有效率(90.3%)明显优于对照组(64.5%),P<0.05.同时,起病24h内开始LMWH治疗的显效率(84.2%)优于起病24～48h才开始LMWH治疗的显效率(41.7%),P<0.02.高峰和低谷血药浓度分别为(0.32±0.17)及(0.26±0.19)anti-XaIU.未发现出血倾向.结论:低分子肝素治疗急性缺血性中风是安全有效的.
Objective: To evaluate the efficacy and safety of low molecular weight heparin (LMWH) in the treatment of acute ischemic stroke.Methods: All cases were treated with low molecular weight dextran, and LMWH was given to the treatment group: 3 cases were transiently transient Cerebral infarction (TIA) and 31 cases of intracerebral infarction within 48h, LMWH4100anti-XaIU, bid, abdominal wall sc, continuous for 10 days.Control group: 31 cases of cerebral infarction.A total of 1 case LMWH concentration was measured by the substrate method.Results: The symptoms of TIA in 3 cases were relieved quickly.The total effective rate (90.3%) in the treatment group was significantly better than that in the control group (64.5%), P <0.05.At the same time, (84.2%) was superior to the effective rate (41.7%) of LMWH treatment starting from 24 to 48 hours, P <0.02.The peak and trough plasma concentrations were 0.32 ± 0.17 and 0.26 ± 0.19 respectively -XaIU no bleeding tendency found.Conclusion: Low molecular weight heparin is safe and effective in the treatment of acute ischemic stroke.