Vorob'eva N M, Panchenko E P, Ermolina O V, Balakhonova T V, Dobrovol'skiĭ A B, Titaeva E V, Khasanova Z B, Postnov A Iu, Kirienko A I
Ter Arkh. 2011;83(8):33-7.
To compare effects of prolongation of the treatment with therapeutic doses of enoxaparin to 1 month on recanalization of occlusively thrombosed deep veins (OTDV) of the limbs with results of standard therapy with unfractionated heparin (UFH). Both treatments were followed by warfarin administration.
Thirty patients were selected from 111 patients with a history of deep vein thrombosis (DVT) and/or pulmonary artery embolism according to the following criteria: the presence of occlusive thrombosis of one deep vein minimum; the absence of DVT for 12 months of follow-up. Patients of group 1 (n = 15) received standard therapy (UFH for at least 5 days) with switch to warfarin. Patients of group 2 (n = 15) received therapeutic doses of enoxaparin (1 mg/kg each 12 hours) for 30 days minimum with switch to warfarin. Follow-up was 12 months. Ultrasonic duplex angioscanning of the limbs was made at baseline, 1, 3, 6 and 12 months after treatment start.
After follow-up month 1, 3 and 6 number of patients with occlusive DVT was significantly less in group 2. All the patients given enoxaparin achieved recanalization of OTDV within 3 months of treatment. OTDV recanalization was not achieved in 20% patients of group 1 even 12 months after treatment start.
Prolongation of enoxaparin treatment to 1 month followed by warfarin treatment is superior to standard UFH treatment followed by warfarin in providing recanalization of OTDV within 3 months of treatment. Moreover, this treatment predicts persistence of recanalization within 12 months of anticoagulant therapy.
比较将治疗剂量的依诺肝素治疗延长至1个月对肢体闭塞性血栓形成的深静脉（OTDV）再通的效果与普通肝素（UFH）标准治疗的结果。两种治疗后均给予华法林。
从111例有深静脉血栓形成（DVT）和/或肺动脉栓塞病史的患者中根据以下标准选择30例患者：至少一条深静脉存在闭塞性血栓形成；随访12个月无DVT。第1组（n = 15）患者接受标准治疗（UFH至少5天）并换用华法林。第2组（n = 15）患者接受治疗剂量的依诺肝素（每12小时1 mg/kg）至少30天并换用华法林。随访12个月。在治疗开始时、治疗开始后1、3、6和12个月对肢体进行超声双功血管扫描。
在随访第1、3和6个月时，第2组闭塞性DVT患者数量明显较少。所有接受依诺肝素治疗的患者在治疗3个月内实现了OTDV再通。第1组2０%的患者即使在治疗开始12个月后仍未实现OTDV再通。
依诺肝素治疗延长至1个月后再给予华法林治疗在治疗3个月内实现OTDV再通方面优于标准UFH治疗后再给予华法林治疗。此外，这种治疗可预测抗凝治疗12个月内再通的持续性。
