瑞替普酶、尿激酶经导管溶栓治疗急性下肢深静脉血栓的疗效观察  

Catheter-directed thrombolytic therapy with use of reteplase and urokinase for the treatment of acute deep venous thrombosis of lower extremity:an observation of clinical results

作　　者：隋守光[1] 王世礼 孙鹏[1] 肖颖[1] 施洪峰[1] 

机构地区：[1]东营滨州医学院附属东营市胜利油田中心医院血管、神经介入科,山东257034 [2]青岛市胶州中心医院放射科

出　　处：《介入放射学杂志》2013年第1期57-60,共4页Journal of Interventional Radiology

摘　　要：目的观察瑞替普酶（rPA）与尿激酶（uK）在急性下肢深静脉血栓（ADVT）溶栓治疗中的临床疗效和不良反应。方法自2008年12月-2012年5月对40例ADVT患者随机分为2组，每组各20例。2组均采用导管溶栓术（CDT），A组给予rPA每日20Mu，B组给予UK每日50万-60万U溶栓，同时加用抗凝、抗血小板药物治疗。观察疗效的临床指标、过敏反应及出血并发症等。结果rPA组溶栓总有效率为100％，UK组总有效率为95％，组间差异无统计学意义（P〉0．05），rPA溶栓起效迅速，较UK具有良好的时效性。两组的过敏反应及出血差异均无统计学意义（P〉0．05）。结论rPA和UK都是治疗ADVT疗效肯定、安全的溶栓药物，rPA溶栓起效迅速，较UK具有良好的时效性。Objective To investigate the clinical efficacy and adverse reactions of catheter-directed thrombolytic therapy with use of reteplase （rPA） and urokinase （UK） in treating acute deep venous thrombosis （ADVT） of lower extremity. Methods During the period from Dec. 2008 to May 2012, a total of 40 patients with ADVT were admitted to author＇s hospital. The patients were randomly and equally divided into tow groups with 20 patients in each group. Catheter-directed thrombolytic therapy was carried out in all patients by using rPA 20 MU for patients in group A and UK （5 - 6） × 10^5 u for patients in group B. Additional anticoagulants and anti-platelet drugs were employed at the same time. Clinical efficacy, allergic reaction and the complication of bleeding were recorded. The results were analyzed. Results The total response rate of group A （rPA） and group B （UK） was 100% and 95% respectively. The difference in the response rate between the two groups was not statistically significant （P 〉 0.05）. Compared with UK, the thrombolysis effect of rPA acted instantly. The time of effectiveness of rPA is satisfactorily longer than that of UK. No significant difference in the occurrence of allergic reaction and bleeding existed between the two greups（P 〉 0.05）. Conclusion Both rPA and UK are safe thrombolytics with reliable effect in treating acute deep venous thrombosis. The rPA acts its thrombolytic effect promptly and carries a longer time of effectiveness than UK does. （ J Intervent Radiol, 2013, 22 ： 057-060）

关 键 词：静脉血栓形成 瑞替普酶 尿激酶 导管溶栓 

分 类 号：R543.6[医药卫生—心血管疾病]