Effect of intermittent use of low molecular heparin on microemboli detected by transcranial Doppler monitoring in patients with ischemic stroke
10.3760/cma.j.issn.1673-4165.2012.03.002
- VernacularTitle:间断性低分子肝素治疗对缺血性卒中患者经颅多普勒监测的微栓子的影响
- Author:
Liangliang WANG
;
Huaiyu HUANG
;
Yong ZHOU
;
Xiangyang ZHU
- Publication Type:Journal Article
- Keywords:
Anticoagulants;
Heparin;
Stroke;
Brain Ischemia;
Ultrasonography,Doppler,Transcranial;
Treatment Outcome
- From:
International Journal of Cerebrovascular Diseases
2012;20(3):165-169
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of intermittent use of low molecular heparin (LMWH) on microembofic signal (MES) in patients with ischemic stroke on the basis of anti-platelet aggregation and statin therapy.Methods Ninety MES-positive patients with acute ischemic stroke detected by transcranial Doppler were randomly divided into a non-LMWH group (n =44) and a LMWH group (n =46).The non-LMWH group was treated conventionally with enteric-coated aspirin and atorvastatin.On the basis of conventional therapy,the LMWH group was treated with LMWH,subcutaneous injection of LMWH calcium 4 100 AXaIU every 3 months,twice a day,and one week as a course of treatment (a total of 3 courses).The number of MES,MES-positive rate and incidence of ischemic cerebrovascular events at 3 and 6 month were compared in both groups.Results There was no significant difference in the MES-positive rates at 3 month after treatment between the non-LMWH group and the LMWH group (70.45％ vs.61.36％ ;x2 =1.357,P =0.244),but the number of MES in the non-LMWH group was higher than that in the LMWH group (12.07 ± 10.16 vs.8.09± 8.13; t =1.470,P =0.043); the MES-positive rate at 6 month after treatment in the non-LMWH group was significantly higher than that in the LMWH group (36.96％ vs.19.57％;x2=3.982,P=0.046),and the number of MES in the non-LMWH group was also significantly higher than that in the LMWH group (10.32 ±9.93 vs. 1.46 ± 3.27; t =5.450,P =0.000).There was no significant difference in incidence of ischemic cerebrovascular events at 3 month (2.17％vs. 9.09％,P =0.198 ),but the incidence of ischemic cerebrovascular events at 6 month in the LMWH group was significantly lower than that in the non-LMWH group (4.35％ vs.20.45％,P =0.025).Conclusions On the basis of anti-platelet aggregation and statin therapy,the intermittent use of LMWH may decrease the MES-positive rate and the incidence of ischemic cerebrovascular events in the MES-positive patients with ischemic stroke at 6 month.
