不同溶栓方案对急性大面积肺血栓栓塞症的溶栓效果  

Analysis on the thrombolytic effects of different thrombolytic regimens during treatment of acute massive pulmonary thromboembolism

作　　者：康丽君[1] 费建文[1] 唐燕[1] 于鹏飞[1] 

机构地区：[1]山东省烟台市烟台山医院,264001

出　　处：《中国医学创新》2010年第15期17-20,共4页Medical Innovation of China

基　　金：国家"十五"科技攻关课题资助项目(2001BA703B15)

摘　　要：目的比较不同溶栓方案治疗急性大面积肺血栓栓塞症的溶栓效果和安全性。方法选取2002年6月～2008年6月在笔者所在医院住院的急性大面积肺血栓栓塞症患者35例,随机分为3组:尿激酶12 h溶栓组、尿激酶2 h溶栓组和rt-PA 50 mg溶栓组。结果 (1)3种溶栓方案的临床总有效率均为100%,各组间均未显示有统计学差异;(2)rt-PA治疗组患者在治疗后24 h,呼吸困难的改善较尿激酶2 h组、尿激酶12 h组明显;(3)溶栓后4 h、8 h、12 h各时间点,尿激酶2 h组与尿激酶12 h组D-二聚体比较有显著性差异(P<0.05);rt-PA组与尿激酶12 h组比较有显著性差异(P<0.05)。结论 (1)三种溶栓方案的疗效(总有效率、病死率)和安全性(主要是出血率)相仿;(2)从溶栓治疗后临床症状的改善,D-二聚体所显示的溶栓速率等方面来看,rt-PA组治疗肺栓塞略优于尿激酶2 h、尿激酶12 h组。Objective To compare the thrombolytic effects and security of different thrombolytic regimens of urokinase and rt - PA during treatment of acute massive pulmonary thromboembolism （PTE）. Methods 35 patients with acute massive PTE hospitalized in our hospital between 2002.6 ~ 2008.6 were enrolled in this study. They were randomly divided into three groups which were 12 h thrombolysis with urokinase,2 h thrombolysis with urokinase and 2 h thrombolysis with rt - PA 50 mg group. Results （ 1 ） The clinical total effective rates of the three thmmbolytic therapy progranls were all 100%. （2） The improvement of dyspnea in MC group after 24 - hour treatment was higher than othe two groups. （3） There was a significant difference （P 〈0.05） in D - Dimer between MA group and MB group at each time point of 4 h,8 h,12 h after thrombolysis, and there was also a significant difference （ P 〈 0.05 ） between MA group and MC group. Cundnsiou The efficacy and safety of the three thrombolytic programs is similar to each other. But the MC group is superior to other two groups in some aspects such as the improvement of clinical symptoms after thrombolysis and the speed of thrombolysis.

关 键 词：肺栓塞 溶栓 尿激酶 rt—PA 

分 类 号：R563.5[医药卫生—呼吸系统]