华法林、低分子肝素序贯疗法对糖尿病合并缺血性脑梗死患者凝血功能的影响及经济学评价
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摘要
目的探讨华法林、低分子肝素(LMWH)序贯疗法对糖尿病合并缺血性脑梗死患者凝血功能的影响,并评价其经济学价值。方法将本院收治的120例糖尿病合并缺血性脑梗死患者按随机数字表法分为对照1组(40例,华法林抗凝+常规治疗)、对照2组(40例,LMWH抗凝+常规治疗)及研究组(40例,华法林、LMWH序贯疗法+常规治疗)。比较三组凝血指标、抗凝费用及出血率。结果治疗后,三组的PT及APTT均升高,D-D及FIB水平均降低,且对照2组和研究组优于对照1组(P<0.05)。研究组和对照2组的抗凝费用均高于对照1组,且对照2组高于研究组。对照2组和研究组的总出血率均低于对照1组(P<0.05)。结论对糖尿病合并缺血性脑梗死患者给予华法林、LMWH序贯疗法的效果和安全性均与LMWH治疗相近,均优于华法林,但是华法林的费用较低。
Objective To investigate the effect of warfarin and low molecular weight heparin(LMWH) sequential therapy on coagulation function in patients with diabetes mellitus complicated with ischemic cerebral infarction, and to evaluate its economic value. Methods A total of 120 patients with diabetes mellitus complicated with ischemic cerebral infarction admitted in our hospital were randomly divided into control group 1(40 cases, warfarin anticoagulation+routine treatment), control group 2(40 cases, LMWH anticoagulation+routine treatment) and research group(40 cases, warfarin, LMWH sequential therapy+routine treatment). The coagulation indexes, anticoagulation costs and bleeding rate were compared between the three groups.Results After treatment, the PT and APTT increased and levels of D-D and FIB decreased in the three groups, and those in the control group 2 and the study group were better than the control group 1(P<0.05). The anticoagulation costs of study group and control group 2 were higher than that of control group 1, and that of the control group 2 was higher than the study group. The total bleeding rate of the control group 2 and the study group were lower than that of the control group 1(P<0.05). Conclusion The efficacy and safety of sequential therapy of warfarin, LMWH for diabetic patients with ischemic cerebral infarction are similar to those of LMWH, which are superior to warfarin, but the cost of warfarin is lower.
Objective To investigate the effect of warfarin and low molecular weight heparin(LMWH) sequential therapy on coagulation function in patients with diabetes mellitus complicated with ischemic cerebral infarction, and to evaluate its economic value. Methods A total of 120 patients with diabetes mellitus complicated with ischemic cerebral infarction admitted in our hospital were randomly divided into control group 1(40 cases, warfarin anticoagulation+routine treatment), control group 2(40 cases, LMWH anticoagulation+routine treatment) and research group(40 cases, warfarin, LMWH sequential therapy+routine treatment). The coagulation indexes, anticoagulation costs and bleeding rate were compared between the three groups.Results After treatment, the PT and APTT increased and levels of D-D and FIB decreased in the three groups, and those in the control group 2 and the study group were better than the control group 1(P<0.05). The anticoagulation costs of study group and control group 2 were higher than that of control group 1, and that of the control group 2 was higher than the study group. The total bleeding rate of the control group 2 and the study group were lower than that of the control group 1(P<0.05). Conclusion The efficacy and safety of sequential therapy of warfarin, LMWH for diabetic patients with ischemic cerebral infarction are similar to those of LMWH, which are superior to warfarin, but the cost of warfarin is lower.
引文
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[2]杨丽.2型糖尿病并发脑梗死神经功能缺损程度及防治措施[J].中国实用神经疾病杂志,2017,20(3):132-134.
[3]张冬,张继明.血清同型半胱氨酸与2型糖尿病患者脑梗死相关性研究[J].天津医药,2016,44(7):902-905.
[4]范国洽,郝慧斌,杨昱,等.2013版《中国2型糖尿病防治指南》解读[J].中国临床医生杂志,2015,44(10):92-94.
[5]周卫东,徐涛,曹学兵,等.认知神经病学[M].北京:军事医学科学出版社,2013:108-110.
[6]冯小萌,纪蒙,王广.糖尿病合并急性脑梗死患者糖化清蛋白水平与抗凝血酶Ⅲ活性的关系研究[J].中国全科医学,2017,20(2):139-143.
[7]黄丽.2型糖尿病并发脑梗死患者颈动脉粥样硬化与vWF、AT的关系[D].承德:承德医学院,2017.
[8]侯文锋.2型糖尿病合并脑梗塞的临床表现与治疗研究[J].实用糖尿病杂志,2017,25(1):47-48.
[9]张宗阳,万迎杰,王水红.华法林用于脑梗死合并房颤患者溶栓治疗的疗效及安全性[J].中国实用神经疾病杂志,2016,19(14):72-73.
[10]佟旭,周全,刘静华,等.低分子肝素早期抗凝治疗大动脉粥样硬化狭窄性脑梗死的效果[J].广东医学,2016,37(1):222-225.