Haley E C, Kassell N F, Torner J C
Department of Neurology, University of Virginia Medical Center, Charlottesville 22908.
Stroke. 1988 Jan;19(1):10-4. doi: 10.1161/01.str.19.1.10.
Anticoagulation with heparin is frequently recommended for patients with progressing ischemic cerebral infarction, yet little data is available detailing the acute results of treatment with this agent. We report the results of continuous intravenous heparin treatment in 36 consecutive patients admitted with progressing ischemic infarction, all of whom had computed tomography scans to exclude the diagnosis of hemorrhage prior to treatment. Overall, 18 of 36 (50%) had continued neurologic worsening despite treatment. The incidence of further worsening was greater in carotid territory infarctions (14 of 19, 74%) than in either vertebrobasilar (2 of 8, 25%) or lacunar (2 of 9, 22%) infarctions (p less than 0.05, Fisher's exact test). These observations suggest that additional controlled studies of the efficacy of heparin in progressing ischemic infarction are warranted.
对于进展性缺血性脑梗死患者，常推荐使用肝素进行抗凝治疗，但关于该药物治疗急性结果的详细数据却很少。我们报告了连续36例因进展性缺血性梗死入院患者接受持续静脉肝素治疗的结果，所有患者在治疗前均进行了计算机断层扫描以排除出血诊断。总体而言，36例患者中有18例（50%）尽管接受了治疗仍出现神经功能持续恶化。颈动脉供血区梗死患者（19例中的14例，74%）进一步恶化的发生率高于椎基底动脉供血区梗死（8例中的2例，25%）或腔隙性梗死（9例中的2例，22%）患者（P<0.05，Fisher精确检验）。这些观察结果表明，有必要对肝素在进展性缺血性梗死中的疗效进行更多对照研究。
