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Heparin treatment of 42 patients with unstable angina Observation


Good effect, are reported below. 1 Data and methods 1.1 General information: Select January 2003 ~ December 2003 hospital inpatient I 88 cases in patients with unstable angina, heart disease, according to 1997 International Union and the World Health Organization classification diagnostic criteria confirmed the diagnosis. Treatment of 42 patients, 24 males and 18 females, aged 41 to 78 years, mean 63.4 years old, tired early onset of angina in 8 patients, worsening in 14 cases, 20 cases of spontaneous angina pectoris. Onset of chest pain patients treated with the corresponding lead ECG ST segment depression with T wave inversion, or 38 cases, sT-segment elevation in 4 cases; the control group of 46 patients, 25 males and 21 females, aged 43 to 81 years, the average 62.9 years old, early onset exertional angina in 9 cases, 15 cases worsening,[link widoczny dla zalogowanych], spontaneous angina in 22 cases, corresponding to the control group lead ECG has sT-segment depression or T wave inversion in 41 cases,[link widoczny dla zalogowanych], sT segment carrying high in 5 cases. The two groups before treatment, gender, age, type of angina pectoris, ECG changes and so the difference was not statistically significant. 1.2 Treatment: Both groups were H service aspirin,[link widoczny dla zalogowanych], 8 a-blockers and intravenous nitrates and other conventional method of treatment of angina pectoris, the treatment group received 100mg intravenous heparin,[link widoczny dla zalogowanych], 1 / d, for 10 days. Degree of improvement after treatment of angina and ECG review. Check coagulation before and after treatment were 4, platelet count, blood,[link widoczny dla zalogowanych], urine, then routine to rule out contraindications, and observe the treatment of heparin after the bleeding and other adverse reactions. 1.3 Efficacy assessment: reference to the Ministry of Health in 1993 to develop a effective: the severity of fatigue improvement of a spontaneous seizure frequency reduction of 2 / 3 or significantly shorter duration of attack; invalid: no improvement of symptoms. (2) ECG: The markedly effective for the restoration of normal or generally normal; effectively increase the sT-segment depression or T wave inversion rise 0.05mv shallow, sT-segment elevation were back down; invalid for the ECG not meet the above criteria. 1.4 Statistical analysis: the efficacy of the two groups with a total effective rate x test, P <0.05 as significant difference. 2 Results 2.1 after treatment, improvement of angina pectoris: Table 1. 2.2 ECG improvement after treatment in both groups: Table 2. 2.3 Adverse reactions: treatment group 1 case of bleeding and other adverse reactions experiment Article ID】 【1008-3073 (2004) 04-0294-01 room no significant change in check. Table 1 angina after treatment, compared to the situation (for example) Note: P <0.05, significant difference between the two groups Table 2 ECG after treatment compared to the situation (for example) Note: 'P <0.05, significant difference unstable angina 3 to discuss the pathophysiology of disease are: coronary atherosclerotic plaque rupture, exposure of collagen fibers and lipid core, causing platelet adhesion, aggregation, release of platelet factor, the formation of blood clots also may be associated with vascular spasm, causing the vessel lumen stenosis or occlusion. Thus these patients the risk of myocardial infarction or sudden death was significantly increased J. Recent studies have found that plaque rupture with coronary artery plaque on intravascular platelet aggregation and thrombosis are the main features of unstable angina. Over time of coronary plaque rupture can occur repeatedly, exposed to the lumen of the collagen fibers, smooth muscle fibers and lipid activation of platelets and coagulation mechanisms leading to thrombosis, myocardial infarction or sudden death in these patients so the risk was significantly increased. Heparin can inhibit thrombin generation, part of the removal of thrombin on platelet aggregation and prevent fibrin formation. Therefore, in the treatment of unstable angina, recent advocate the use of aspirin, subcutaneous heparin or H clothing and intravenous injection to prevent thrombosis. We found that heparin treatment of unstable angina compared with the control group effect is significant (P <0.05), and no obvious side effects, safety, and is the ideal treatment.