【摘要】：目的:探討蚓激酶對(duì)急性中危肺血栓栓塞的治療效果及安全性。方法:回顧性分析2010年1月至2015年10月在湖南省人民醫(yī)院住院治療的60例急性中危肺血栓栓塞患者的臨床資料,依據(jù)治療方式不同分為蚓激酶組(蚓激酶聯(lián)合低分子肝素鈉序貫華法林組)和對(duì)照組(低分子肝素鈉序貫華法林組),每組30例。比較兩組在治療前、治療后10,20及30 d的臨床療效及安全性。結(jié)果:CT肺動(dòng)脈造影(CT pulmonary angiography,CTPA)和超聲心動(dòng)圖結(jié)果表明蚓激酶組右心室最大短軸直徑、左心室最大短軸直徑、右心室最大短軸直徑與左心室最大短軸直徑比值、肺動(dòng)脈收縮壓和主肺動(dòng)脈直徑在治療后10,20及30 d與對(duì)照組比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05),且兩組在治療后10,20及30 d比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。與對(duì)照組比較,蚓激酶組N末端B型腦鈉肽原(NT-pro BNP)在治療后10,20和30 d明顯降低(P0.05)。對(duì)照組和蚓激酶組氧分壓(PO2)在治療后10,20和30 d明顯升高,但治療后20和30 d兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。D-二聚體在對(duì)照組和蚓激酶組治療后10 d明顯增高,而在治療后20,30 d明顯降低,且兩組及組內(nèi)比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。蚓激酶組臨床療效優(yōu)于對(duì)照組(P0.05)。結(jié)論:蚓激酶聯(lián)合低分子肝素鈉序貫華法林治療急性中危肺血栓栓塞患者臨床療效顯著且安全,值得臨床推廣。
[Abstract]:Objective: to evaluate the efficacy and safety of lumbrokinase in the treatment of acute moderate pulmonary thromboembolism. Methods: the clinical data of 60 patients with acute pulmonary thromboembolism in Hunan Provincial people's Hospital from January 2010 to October 2015 were analyzed retrospectively. The patients were divided into two groups: lumbrokinase group (lumbrokinase combined with low-molecular-weight heparin sodium sequential warfarin group) and control group (low-molecular-weight heparin sodium sequential warfarin group) with 30 cases in each group. The clinical efficacy and safety of the two groups were compared before and 10 ~ 20 and 30 days after treatment. Results: the results of CT pulmonary angiography (CT pulmonary angiography,CTPA) and echocardiography showed that the right ventricular maximum short axis diameter, left ventricular maximum short axis diameter and the ratio of right ventricular maximum short axis diameter to left ventricular maximum short axis diameter were found in lumbrokinase group. Pulmonary artery systolic pressure and diameter of main pulmonary artery were significantly different from those of control group at 10 ~ 20 and 30 days after treatment (P0.05), and there were significant differences between two groups at 10 ~ 20 and 30 days after treatment (P0.05). Compared with the control group, the N-terminal B-type brain natriuretic peptide (NT-pro BNP) in the lumbrokinase group was significantly decreased at the 20th and 30th days after treatment (P0.05). The oxygen partial pressure (PO2) in the control group and the lumbrokinase group was significantly increased at the 20th and 30th days after treatment, but there was no significant difference between the two groups 20 and 30 days after treatment (P0.05). The D-dimer was significantly increased 10 days after treatment in the control group and the lumbrokinase group. However, it was significantly decreased at 30 days after treatment, and the difference between the two groups was statistically significant (P0.05). The clinical effect of lumbrokinase group was better than that of control group (P0.05). Conclusion: the clinical efficacy of lumbrokinase combined with low-molecular-weight heparin sodium warfarin in the treatment of patients with acute pulmonary thromboembolism is significant and safe.
【作者單位】： 湖南省人民醫(yī)院呼吸內(nèi)科;中南大學(xué)湘雅三醫(yī)院康復(fù)科;
【基金】：湖南省中醫(yī)藥管理局基金(201547) 湖南省科技廳科技計(jì)劃項(xiàng)目(2013FJ4098) 湖南省衛(wèi)生廳科研項(xiàng)目(B2014-38)~~
【分類號(hào)】：R563.5

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