机械心脏门更换后的低分子量肝素
G Montalescot1, V Polle, J P Collet
1Departments of Cardiology, Pitié-Salpétrière Hospital, Paris, France. gilles.montalescot@psl.ap-hop-paris.fr
Circulation
|March 15, 2000
概括
低分子量氨酸 (LMWH) 提供了可行的和有效的抗凝剂,用于机械心脏门的患者,相比较有利于未分离氨酸 (UH). 对于这种新方法,建议进行进一步的随机试验.
科学领域:
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
- 血液学 血液学 血液学
背景情况:
- 机械心脏门需要为患者提供终身抗凝治疗.
- 本研究研究低分子量肝素 (LMWH) 作为机械心脏门更换后的替代性抗凝方法.
研究的目的:
- 在患有机械心脏门的患者中,比较低分子量肝素 (LMWH) 与未分离肝素 (UH) 的疗效和安全性.
- 评估LMWH在这个患者群体中提供的可行性和生物抗凝剂.
主要方法:
- 一项非随机的比较研究,涉及208名连续接受机械心脏门置换手术的患者.
- 患者接受了不分离的肝素 (UH) (n=106) 或低分子量肝素 (LMWH) (n=102) 的抗凝药.
- 使用激活的部分血栓形成时间 (aPTT) 对UH和LMWH的抗Xa活性来监测治疗范围.
主要成果:
- 在第二天,LMWH在87%的患者中实现了治疗性抗Xa活性,明显高于UH的9%治疗性aPTT.
- 在最后一天,所有LMWH患者保持了足够的抗Xa水平,而62%的UH患者有过度抗凝血.
- 在各组之间,出血事件是相似的 (每组有两个主要事件),在UH组中发生了一次中风.
结论:
- 机械心脏门置换后使用LMWH进行抗凝治疗是可行的,并提供足够的生物抗凝治疗.
- 在这项初步研究中,LMWH与UH进行了有利的比较.
- 随机对照试验是有必要的,以进一步验证LMWH作为治疗选择.
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