Ol'binskaia L I, Kolosova K Iu, Nesterova S G, Egorova T D, Fedorova A Iu
Kardiologiia. 2005;45(12):93-8.
Modern approaches to prevention of venous thromboembolic complications in patients with chronic heart failure are analyzed in this review which contains results of large studies of low molecular weight heparins. In MEDENOX trial the use of enoxaparin in medical patients was associated with 63% reduction of risk of thrombosis. The authors own experience showed that 2 weeks of therapy with enoxaparin in patients with chronic stage IIB-III heart failure caused significant lowering of soluble fibrin-monomer complexes, fibrinogen, and index of turbo-dynamic potential. These changes evidenced for decreased intravascular blood coagulation. Thus enoxaparin can be effectively used for prevention of thrombosis and thromboembolism in patients with chronic heart failure. Novel antithrombotic agents fondaparinux, idraparinux, ximelagatran, recombinant thrombomodulin are perspective medications for prevention of venous thromboses and embolism in medical patients.
本综述分析了慢性心力衰竭患者预防静脉血栓栓塞并发症的现代方法,其中包含低分子量肝素的大型研究结果。在MEDENOX试验中,依诺肝素用于内科患者可使血栓形成风险降低63%。作者自身经验表明,对IIB-III期慢性心力衰竭患者使用依诺肝素治疗2周可显著降低可溶性纤维蛋白单体复合物、纤维蛋白原和血流动力学潜能指数。这些变化证明血管内血液凝固减少。因此,依诺肝素可有效用于预防慢性心力衰竭患者的血栓形成和血栓栓塞。新型抗血栓药物磺达肝癸钠、依达肝素、希美加群、重组血栓调节蛋白是预防内科患者静脉血栓形成和栓塞的有前景的药物。