目的　前瞻性的评价无ST段抬高的急性冠状动脉 (冠脉 )综合征患者接受冠脉介入治疗前应用依诺肝素的安全性和有效性。方法　急性冠脉综合征患者入院后给予依诺肝素 1mg/kg ,皮下 ,1 /1 2h ,至少 48h ,在最后一次注射后 8h内行介入检查或治疗。术中 /术后不再追加肝素或低分子肝素。部分病人术后集中测定抗Xa因子活性。结果　 50 7例患者完成了本研究。 1 76例 (93 .2 % )的患者抗Xa因子活性 >0 .5IU/ml。30d内的随访中 ,急性心肌梗死 1 6例 (3 .2 % ) ,再发不稳定性心绞痛 34例 (6 .7% ) ,1例 (0 .2 % )进行了血运重建 ,1例死亡 (十二指肠穿孔 )。轻微出血 2 4例 ,占 4 7%。30d后的随访有 1例发生非Q波心肌梗死 ,1例再发不稳定性心绞痛。结论　高危急性冠脉综合征病人皮下注射依诺肝素至少 48h ,最后一次注射 8h内行介入检查或治疗 ,不再给抗凝制剂 ,对病人安全有效 Objective To prospectively evaluate the safety and efficacy of enoxaparin before PCI in patients with acute coronary syndrome (ACS) without ST segment elevation. Methods Patients with acute coronary syndrome were given enoxaparin 1 mg / kg, subcutaneously, 1/12 h, at least 48 h after admission, and their interventional therapy was performed within 8 h after the last injection. Intraoperative / postoperative no additional heparin or low molecular weight heparin. Some patients concentrated after surgery to determine anti-factor Xa activity. Results Fifty-seven patients completed the study. In 76 (93.2%) patients, anti-Xa activity was> 0.5 IU / ml. During the follow-up period of 30 days, 16 cases (3.2%) of acute myocardial infarction, 34 cases (6.7%) of unstable angina recurrence and 1 case (0.2%) underwent revascularization and 1 case Death (duodenal perforation). 24 cases of mild bleeding, accounting for 47%. One case of non-Q-wave myocardial infarction occurred after 30 days and one case of recurrent unstable angina. Conclusion Patients with high-risk acute coronary syndrome received subcutaneous injection of enoxaparin for at least 48 hours and the last injection within 8 hours for interventional check-up or treatment. No anticoagulant was given and the patient was safe and effective