【摘要】 目的观察低分子肝素(Low molecular weight heparin,LMWH)对脑梗死(Cerebral infarction,CI)患者甲襞微循环的动态影响和疗效。方法按入院的先后随机将入选的CI病例分为LMWH组和对照组。LMWH组(n=25)予LMWH5000抗XaIU腹壁皮下注射,2次/d,共7d;对照组(n=30)予阿司匹林肠溶片口服,100mg/d。LMWH组患者分别于LMWH注射前和治疗后1h、2h、3h、4h、5h、6h、7h、治疗后第8天检查甲襞微循环,对照组分别于治疗前和治疗后第8天检查甲襞微循环。两组患者治疗前、治疗后第8天进行神经功能缺损程度评分和疗效评定。结果与治疗前比较,LMWH组治疗后2h～5h甲襞微循环总积分明显下降(P<0.01),尤其以治疗后3h最明显。LMWH组、对照组的总有效率88%和60%,两者差异有统计学意义(P<0.05)。两组治疗前后的神经功能缺损评分、甲襞微循环总分对比差异有统计学意义(P<0.05或P<0.01),LMWH组治疗前后神经功能缺损评分、甲襞微循环总分减分率分别为0.60±0.33和0.32±0.26,两者呈正相关(r=0.47,P<0.05)。结论LMWH可有效改善CI患者的微循环状态,改善其神经功能和预后,是CI早期治疗的有效手段之一。更多还原

【Abstract】 Objective To observe the clinical effect of Low molecular weight heparin (LMWH) and its dynamic impact for nail fold microcirculation in patients with cerebral infarction (CI). Methods According to the admitted date, the patients with CI were randomly divided into LMWH group and control group. The LMWH group (n=25) was treated with LMWH 5000 anti-Xa IU through hypo in abdominal wall twice a day for 7 days, and the control group (n=30) was treated with aspirin 100mg once a day. The examinaltion of nail fold microcirculation was checked in LMWH group before the treatment of LMWH and after the treatment 1hs,, 2h s,, 3h s,, 4h s,, 5h s,, 6h s,, 7h s, time, as well as the 8th day, control group was checked, and in LMWH group before the medicine for aspirin and after treatment the 8th day. The neurologic impairment score and effectiveness of LMWH group and control group were evaluated before and after treatment. Results The mean score of nail fold microcirculation of LMWH group significantly decreased in 2h~5h after being treated with LMWH (P <0.01) especially at 3h. Total effective rate of LMWH group and control group were 88% and 60% respectively, and there were remarkable differences between the two groups (P <0.05). After treatmlnt in LMWH group and control group, the neurologic impairment score and mean score of nail fold microcirculation were significantly lower than those of pretherapy (P <0.05 or P <0.01). and in the LMWH group, the decreasing rate of neurologic impairment score and mean score of nail fold microcirculation were 0.60±0.33 and 0.32±0.26 respectively, and both of them existed positive correlation (r=0.47, P<0.05). Conclusion LMWH could effectively improve microcirculation state, neurologic impairment and prognosis of patients with CI, so it might be one of the effective methods to treat CI at the early stage.更多还原