低分子量肝素作为桥梁抗凝剂在机械心脏门更换后的早期
Philippe Meurin1, Jean Yves Tabet, Hélène Weber
1Les Grands Prés, Villeneuve Saint Denis, France. philippemeurin@hotmail.com
Circulation
|February 2, 2006
概括
低分子量氨酸,特别是埃诺沙巴林,在维生素K对抗剂尚未有效时,对于机械心脏置换后的患者来说,是一种可行的桥梁抗凝药选择. 这种方法可以在高风险的术后期降低血栓栓塞的风险.
科学领域:
- 心脏病学 心脏病学
- 血管外科 血管外科
- 药理学 药理学是指药理学的学科.
背景情况:
- 机械心脏门置换 (MHVR) 通常需要抗凝药.
- 维生素K对抗剂 (VKA) 可能是禁忌的,或者在MHVR后达到治疗水平的速度很慢.
- 有时使用未分离的氨酸,但正在探索低分子量氨酸 (LMWH) 的可行性.
研究的目的:
- 调查使用埃诺沙巴林 (LMWH) 作为MHVR后患者的桥梁抗凝药的可行性.
- 评估尚未接受有效VKA治疗的患者的安全性和疗效.
主要方法:
- 对695名转移到心脏康复中心的MHVR患者进行前性研究.
- 招募了250名患者,在VKA有效之前,他们接受素而不是未分离的肝素,直到VKA有效.
- 患者进行了90天的随访,监测出血,血栓栓塞和膜血栓.
主要成果:
- 埃诺沙巴林治疗的平均时间为8.3天.
- 发生了两次主要和三次轻微出血.
- 据报道,有一次过渡性缺血性发作.
- 没有观察到膜血栓塞或死亡.
结论:
- 对于MHVR后的患者来说,以诺沙林桥梁抗凝药是可行的.
- 在VKA治疗完全治疗之前,这种策略在高风险时期是有效的.
- 在特定的MHVR患者中,LMWH可能会缩短住院时间.
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