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目的 探讨脂蛋白 (a) [Lp(a) ]在短暂性脑缺血发作 (TIA)中的作用及其有效的治疗方法。 方法 对 6 0例频繁发作性TIA患者Lp(a)水平进行检测 ,设立对照组。然后将 6 0例患者随机分为 3组 ,每组2 0例 ,分别应用抗凝剂 (低分子肝素 )、降纤药物 (降纤酶 )、抗血小板药物 (阿司匹林 )治疗 ,疗程均为一周 ,观察每组的疗效及半年后的复发率。结果 TIA组Lp(a)水平 [中位数 (M )为36 7.5 3mg/L]较对照组(15 6 .16mg/L)显著升高 (P <0 .0 1) ;低分子肝素组、降纤酶组、阿司匹林组有效率分别为 0 .90、0 .35、0 .40 ;各组半年后的复发率分别为 0 .0 5、0 .71、0 .6 2。结论 高水平的Lp(a)是TIA频繁发作的重要原因 ;抗凝剂可有效地防治TIA的频繁发作。
Objective To investigate the role of lipoprotein (a) [Lp (a)] in transient ischemic attack (TIA) and its effective treatment. Methods Sixty patients with frequent episodic TIA were tested for Lp (a) levels and a control group was established. Then, 60 patients were randomly divided into 3 groups, 20 cases in each group, and were treated with anticoagulant (low molecular weight heparin), fibrinolytic drugs (defibrase) and antiplatelet drugs (aspirin) for one week The curative effect of each group and the recurrence rate after six months were observed. Results The level of Lp (a) in TIA group was significantly higher than that in control group (36.6 mg / L vs 36.6 mg / L, P <0.01) The effective rates of defibrase group and aspirin group were 0 .90,0. 35,0. 40 respectively. The recurrence rates of each group after 6 months were 0. Conclusion High level of Lp (a) is an important cause of frequent episodes of TIA. Anticoagulants can effectively prevent and treat frequent episodes of TIA.