Forette B, Wolmark Y
Hôpital Sainte-Périne, Paris.
Presse Med. 1995 Mar 25;24(12):567-71.
To evaluate the safety of a low molecular weight heparin for the prevention of thromboembolic disease in elderly patients.
A multicentre, randomized, open study was conducted in 295 patients: 146 patients (mean age 82.8 +/- 0.5 years) received calcium nadroparin and 149 patients (mean age 83.8 +/- 0.6 years) received calcium heparin. All medical patients were hospitalized with transient locomotor disability, requiring prophylaxis for thromboembolism. Patients were randomized to 28-days treatments with either subcutaneous calcium nadroparin 0.3 ml (3075 anti-Xa IU) daily or subcutaneous calcium heparin twice a day (0.2 ml-5000 UI--if bodyweight was less than 70 kg or 0.3 ml-7500 IU--if bodyweight was over or equal to 70 kg).
The overall objective was to assess tolerability in terms of premature discontinuation of treatment for any reason: Discontinuation was more frequent in the calcium heparin group (16.1%) than in the calcium nadroparin group (11%), but without statistical significance. Premature withdrawal of therapy definitively attributable to drug administration occurred in 10 patients from the calcium heparin group (1 deep vein thrombus, 1 pulmonary embolus, 4 major bleeding events, 1 thrombopenia, 3 allergic events) and in only 1 from the calcium nadroparin group (1 allergic event). The difference was statistically significant (p = 0.01).
The results of this study offer new evidence to confirm the safety and simplicity of administration of calcium nadroparin in the prevention of thromboembolism in elderly patients.
评估低分子量肝素预防老年患者血栓栓塞性疾病的安全性。
对295例患者进行了一项多中心、随机、开放研究:146例患者(平均年龄82.8±0.5岁)接受那屈肝素钙治疗,149例患者(平均年龄83.8±0.6岁)接受肝素钙治疗。所有内科患者均因短暂运动功能障碍住院,需要进行血栓栓塞预防。患者被随机分为接受以下治疗28天:皮下注射那屈肝素钙0.3 ml(3075抗Xa国际单位)每日一次,或皮下注射肝素钙每日两次(体重小于70 kg者为0.2 ml - 5000国际单位,体重大于或等于70 kg者为0.3 ml - 7500国际单位)。
总体目标是评估因任何原因提前停药的耐受性:肝素钙组的停药率(16.1%)高于那屈肝素钙组(11%),但无统计学意义。肝素钙组有10例患者(1例深静脉血栓、1例肺栓塞、4例大出血事件、1例血小板减少症、3例过敏事件)因明确与药物给药相关而提前停药,而那屈肝素钙组仅有1例(1例过敏事件)。差异具有统计学意义(p = 0.01)。
本研究结果提供了新的证据,证实了那屈肝素钙在预防老年患者血栓栓塞方面的安全性和给药简便性。