Deitcher S R
Am J Manag Care. 2000 Nov;6(20 Suppl):S1026-33.
Standard medical treatment for patients with acute venous thrombosis is antithrombotic therapy. Following a historical overview of the evolution of heparin therapy to include low-molecular weight heparin (LMWH), the pharmacokinetic properties of enoxaparin are described. Therapeutic advantages of LMWH over unfractionated heparin (UFH) are also discussed, including once- or twice-daily subcutaneous dosing, reduced hospital stays, elimination of therapeutic monitoring for most patients, and possibly less bone density loss. Studies have demonstrated that enoxaparin is at least equivalent to UFH with regard to efficacy and safety. Opportunities for future study include evaluation of enoxaparin's efficacy for the prevention of deep vein thrombosis within high-risk groups and for the treatment of thrombosis in such conditions as pregnancy, cancer, obesity, and renal insufficiency, and in children.
急性静脉血栓形成患者的标准医学治疗方法是抗栓治疗。在对肝素治疗(包括低分子量肝素[LMWH])的演变进行历史概述之后,描述了依诺肝素的药代动力学特性。还讨论了LMWH相对于普通肝素(UFH)的治疗优势,包括每日一次或两次皮下给药、缩短住院时间、大多数患者无需进行治疗监测以及可能减少骨密度损失。研究表明,依诺肝素在疗效和安全性方面至少与UFH相当。未来的研究机会包括评估依诺肝素在高危人群中预防深静脉血栓形成的疗效,以及在妊娠、癌症、肥胖、肾功能不全等情况下以及儿童中治疗血栓形成的疗效。