那曲肝素钙。回顾其药理学和临床使用血栓栓塞疾病的预防和治疗。
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戴维斯R, Faulds D
那曲肝素钙。回顾其药理学和临床使用血栓栓塞疾病的预防和治疗。
衰老药物。1997年4月;(4):299 - 322。
- PubMed ID
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9108990 (在PubMed]
- 文摘
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那曲肝素(那曲肝素钙)是一种低分子量肝素平均分子量为4.5 kD。与依诺肝素(能)相比,那曲肝素具有更大的比anti-factor Xa anti-factor公顷活动,更大的生物利用度和较长时间行动,允许它由皮下注射血栓栓塞的预防或治疗疾病。在临床试验在老年患者进行(通常平均年龄> 60岁),那曲肝素至少像素能有效预防深静脉血栓形成(DVT)和少将或骨科手术后肺栓塞,卧床不起的病人。那曲肝素也至少有效dalteparin或口头苊香豆醇在预防血栓栓塞事件一般骨科手术后,分别。当用于治疗深静脉血栓形成,那曲肝素至少像静脉注射能有效。皮下那曲肝素,在剂量类似用于深静脉血栓形成的治疗,取得了可喜的成果在老年患者肺栓塞、急性缺血性中风或不稳定性心绞痛。在1的研究中,75%的nadroparin-treated患者能够完成他们的治疗,36%不需要入院;这些结果的潜在pharmacoeconomic影响值得进一步评估。整体治疗费用(药物采集和监测成本)是相似的那曲肝素和超高频在法国的一项研究中,但那曲肝素治疗与护理时间大大减少。那曲肝素是由老年患者耐受良好。 The most frequently reported adverse events in a large (n approximately 4500) placebo-controlled study in general surgical patients were wound and injection site haematoma (11.8 and 10.2%, respectively, vs approximately 6.5% for placebo). When used as prophylaxis, no significant differences in bleeding complications were noted between nadroparin and UFH or acenocoumarol recipients. Prophylactic nadroparin was associated with significantly fewer withdrawals because of adverse events than UFH in elderly bedridden medical patients. When used as treatment for DVT, nadroparin was generally associated with lower occurrences of major bleeding than intravenous UFH (0.5 to 2.3% vs 2 to 5%); however, trials were not large enough to demonstrate any significant differences between the 2 agents. Similarly, the incidence of thrombocytopenia was slightly, but generally not significantly, lower in nadroparin (< 1%) than in UFH (< or = 3.5%) recipients. Thus, nadroparin should be considered an effective and well tolerated alternative to UFH for prophylaxis and treatment of DVT in older patients, with the advantage of more convenient administration and decreased monitoring requirements.