Althought there are controversies regarding the appropriate dosage and the best monitoring method, heparin is the most widely used anticoagulant. Recent reports indicate that continuous infusion appears safer and is as effective as intermittent
intravenous infusion in thromboembolic diseases. The therapeutic amount has been determinated on the assumption of lowest of thrombosis and bleeding. However, several studies indicate that standardized doses of heparin can induce unpredictable
anticoagulation in some patients. Recently, a new method ior measuring the plamsma beparin concentration using a chromogenic substrate is available.
We desinged this study to evaluate the accuracy of aPTT in the monitoring of heparin therapy and define the appropriat dosage and methods for infusion in patients withacute cerebral infarction. Among the patients with acute cerebral infarction
and
admitted acute cerebral infaretion. Among the patients wiith acute cerebral infarction and admitted to neurooogy department from June 1989 to December 1989, 13 patients were enrolled. They were divided ito two groups according to the heparin
dosage
and
using bolus bolus infusion or not. Group 1 included 6 patients (4men, 2 women) treated with 15,000 unit/day. Group 2 included 7 patients (5 men, 2 women) treated with contionus infusion of 10.000 unit/day. Their mean age were 55.2 and 60.1 years
old,
respectively.
we measured the baseline plasma heparin level, aPTT, antithrombin Ⅲ and platelet and 1, 24, 48, 96 and 120 hours after starting therapy. The mean of the aPTT and heparin concentration of 1, 24 hour after infusion of the group 1 increased
markedly
near
to the 3 times of control value. But the all value of the group 2 remained constratly in therapeutic range during the study.
The best method of heparin administration to maintain an effective therapeutic range is continous intravenous jnfusion. The results of this study indicate that treatment of acute cerebral infarction with continous intravenous infusion of 10,000
unit/day
of heparin is more effective and safer than bolus infusion followed by 15,000 unit/day of continous infusion.
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