论文部分内容阅读
心绞痛发作趋于频繁常常伴有血浆纤维蛋白肽A(FPA)水平增高,提示凝血酶生成增多。 40～69岁的24(男18、女16)例自发性心绞痛(伴ST段移位)患者经内科治疗(不包括β阻滞剂和抗血小板药物)有效。出院后按照随机、单盲和交叉的方式,给予肝素钙(12500 IU,每日一次皮下注射)或安慰剂各6个月。每15天随诊一次,至少12个月。每次采血测定血浆FPA水平(放射免疫法)。根据15天内心绞痛发作频度和心电图表现,分成3级;0级无心绞痛且心电图正常;Ⅰ级心绞痛发作1～3次(非同一天内)且新有ST段移位0.2mV;Ⅱ级心绞痛发作≥4次且需由医院给予适当治疗(并采血测定血浆FPA水平)。凡有下列情况者已经除外:心肌梗塞史,左室喷血分数 <45％,收缩压>110mmHg且未能控制,瓣膜性心脏病等需抗凝治疗,恶性疾病影响长期随访。
Angina attacks tend to be more frequent and often accompanied by an increase in plasma fibronectin A (FPA) levels, suggesting an increase in thrombin generation. Patients 40 to 69 years of age (18 males, 16 females) with spontaneous angina (with ST segment displacement) were treated with medical therapy (excluding beta blockers and antiplatelet drugs). After discharge, heparin calcium (12500 IU, subcutaneously once daily) or placebo was given for 6 months in a randomized, single-blind and crossover manner. Follow up every 15 days for at least 12 months. Plasma FPA levels were determined every time blood was collected (radioimmunoassay). According to the frequency of 15 days of angina attacks and ECG performance, divided into 3; 0 no angina and ECG normal; grade angina pectoris 1 to 3 times (within the same day) and the new ST segment shift 0.2mV; grade angina pectoris attack ≥4 times and need to be given appropriate treatment by the hospital (and blood sampling for determination of plasma FPA level). Patients were excluded except for history of myocardial infarction, left ventricular ejection fraction <45%, systolic blood pressure> 110 mmHg, failure to control, valvular heart disease and other anticoagulant therapy, and long-term follow-up of malignant diseases.