蚓激酶对急性中危肺血栓栓塞的治疗作用

发布时间：2018-12-08 12:26

【摘要】：目的:探讨蚓激酶对急性中危肺血栓栓塞的治疗效果及安全性。方法:回顾性分析2010年1月至2015年10月在湖南省人民医院住院治疗的60例急性中危肺血栓栓塞患者的临床资料,依据治疗方式不同分为蚓激酶组(蚓激酶联合低分子肝素钠序贯华法林组)和对照组(低分子肝素钠序贯华法林组),每组30例。比较两组在治疗前、治疗后10,20及30 d的临床疗效及安全性。结果:CT肺动脉造影(CT pulmonary angiography,CTPA)和超声心动图结果表明蚓激酶组右心室最大短轴直径、左心室最大短轴直径、右心室最大短轴直径与左心室最大短轴直径比值、肺动脉收缩压和主肺动脉直径在治疗后10,20及30 d与对照组比较差异均有统计学意义(P0.05),且两组在治疗后10,20及30 d比较差异均有统计学意义(P0.05)。与对照组比较,蚓激酶组N末端B型脑钠肽原(NT-pro BNP)在治疗后10,20和30 d明显降低(P0.05)。对照组和蚓激酶组氧分压(PO2)在治疗后10,20和30 d明显升高,但治疗后20和30 d两组比较差异无统计学意义(P0.05)。D-二聚体在对照组和蚓激酶组治疗后10 d明显增高,而在治疗后20,30 d明显降低,且两组及组内比较差异均有统计学意义(P0.05)。蚓激酶组临床疗效优于对照组(P0.05)。结论:蚓激酶联合低分子肝素钠序贯华法林治疗急性中危肺血栓栓塞患者临床疗效显著且安全,值得临床推广。
[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.
【作者单位】：湖南省人民医院呼吸内科;中南大学湘雅三医院康复科;
【基金】：湖南省中医药管理局基金(201547) 湖南省科技厅科技计划项目(2013FJ4098) 湖南省卫生厅科研项目(B2014-38)~~
【分类号】：R563.5

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