Huet Y, Janvier G, Bendriss P H, Winnock S, Dugrais G, Freyburger G, Boisseras P
Laboratoire Pharmuka Rhône-Poulenc, Paris, France.
Acta Chir Scand Suppl. 1990;556:116-20.
Unfractionated heparin is effective in the treatment of deep venous thrombosis and pulmonary embolism but may lead to significant side-effects (bleeding complications and thrombocytopenia). Low molecular weight heparin fragments have been shown to be as effective as unfractionated heparins during prophylaxis with a once-daily injection regimen. The aim of this open study was to assess the tolerance and the efficacy of enoxaparin in established venous thromboembolism. The study included 36 consecutive patients (mean age 60 years) (range 13-87) with recent deep vein thrombosis (less than 5 days) documented by venography. All patients received enoxaparin twice daily at a fixed dosage of 2 mg/kg/day. The efficacy was assessed by the evolution of Arnesen venographic score. Seventeen patients showed a moderate improvement (less than 35%) and 17 patients had a marked improvement (over 35%). Two patients were not evaluated for efficacy because they displayed bleeding complications. No relationship was found between anti-Factor Xa level and regression of venographic score. In conclusion, subcutaneous administration of enoxaparin proved to be an effective antithrombotic therapy. A fixed dosage of 2 mg/kg/24 h should be the basis of the randomized controlled study ongoing at the present time.
普通肝素对治疗深静脉血栓形成和肺栓塞有效，但可能导致严重的副作用（出血并发症和血小板减少症）。低分子量肝素片段在采用每日一次注射方案进行预防时已被证明与普通肝素同样有效。这项开放性研究的目的是评估依诺肝素在已确诊的静脉血栓栓塞中的耐受性和疗效。该研究纳入了36例连续的患者（平均年龄60岁）（范围13 - 87岁），这些患者经静脉造影证实近期患有深静脉血栓形成（小于5天）。所有患者均接受依诺肝素治疗，每日两次，固定剂量为2mg/kg/天。通过阿内森静脉造影评分的变化来评估疗效。17例患者显示中度改善（小于35%），17例患者有显著改善（超过35%）。2例患者因出现出血并发症而未评估疗效。未发现抗Xa因子水平与静脉造影评分的消退之间存在关联。总之，皮下注射依诺肝素被证明是一种有效的抗血栓治疗方法。2mg/kg/24h的固定剂量应作为目前正在进行的随机对照研究的基础。
