McCarthy S T, Turner J
Age Ageing. 1986 Mar;15(2):84-8. doi: 10.1093/ageing/15.2.84.
Venous thrombo-embolism is a major and often unrecognized cause of morbidity and mortality in patients after acute strokes. Three hundred and five elderly patients were randomly allocated to either control (161) or treatment (144) with 5000 units calcium heparin subcutaneously 8-hourly for two weeks. A reduction in deep-vein thrombosis rate from 72.7% in the control group to 22.2% in treatment patients was achieved. In patients who died (84), post-mortem examination to look for pulmonary emboli was performed in 71. Comparison between treated and untreated patients showed significantly fewer deaths and pulmonary emboli in the treated group. Most of the beneficial effect on mortality was seen in patients with lighter strokes. When patients with pulmonary emboli at post-mortem were excluded, there was no significant difference in the death rate in treatment (17) and control (14) groups. At post-mortem, 9.9% of the strokes were haemorrhagic (4 in the treatment and 3 in the control group). Low-dose calcium heparin given subcutaneously following acute stroke reduced the number of deep-vein thromboses, pulmonary emboli and deaths without increasing the number of haemorrhagic strokes in this study.
静脉血栓栓塞是急性中风患者发病和死亡的主要原因，且常常未被认识到。305名老年患者被随机分为对照组（161例）和治疗组（144例），治疗组每8小时皮下注射5000单位钙肝素，持续两周。治疗组患者深静脉血栓形成率从对照组的72.7%降至22.2%。在死亡的患者（84例）中，71例进行了尸检以寻找肺栓塞。治疗组和未治疗组患者的比较显示，治疗组的死亡和肺栓塞明显减少。对死亡率的大部分有益影响见于中风较轻的患者。排除尸检时有肺栓塞的患者后，治疗组（17例）和对照组（14例）的死亡率无显著差异。尸检时，9.9%的中风为出血性（治疗组4例，对照组3例）。在本研究中，急性中风后皮下注射低剂量钙肝素可减少深静脉血栓形成、肺栓塞和死亡的数量，且不增加出血性中风的数量。
