小剂量尿激酶治疗慢性肺栓塞的疗效及安全性分析  

Analysis of curative effect and safety of small dose of urokinase in the treatment of chronic pulmonary embolism

作　　者：杨惠敏 李莉 杨晓芳 

机构地区：[1]漯河市第六人民医院心内科,462000

出　　处：《中国现代药物应用》2015年第16期34-36,共3页Chinese Journal of Modern Drug Application

摘　　要：目的探讨小剂量尿激酶溶栓治疗慢性肺栓塞的治疗效果及安全性。方法 30例符合诊断标准的慢性肺栓塞患者,用小剂量尿激酶（50万U）缓慢溶栓治疗,观察统计分析临床症状、D-二聚体、肺CT血管成像（CTA）等改善情况。结果 30例患者临床症状均明显改善,呼吸困难、胸闷明显缓解,发绀消失,活动耐量较前明显提高。下肢肿胀减轻或消失,皮温正常,皮肤颜色变浅,浅静脉怒张明显缓解。治疗后心率明显下降,维持在75-90次/min,呈窦性心律,三尖瓣区收缩期杂音明显减低,肺动脉瓣区第2心音（P2）〉主动脉瓣区第2心音（A2）。复查D-二聚体转阴,肺CTA示原来栓塞部位大部分再通,肺动脉压下降,3例恢复正常。结论小剂量尿激酶溶栓治疗慢性肺栓塞疗效确切、安全。Objective To investigate curative effect and safety of small dose of urokinase in the treatment of chronic pulmonary embolism. Methods There were 30 patients with chronic pulmonary embolism according with diagnostic criteria. Small dose of urokinase（500 thousand U） was applied in slow thrombolysis treatment. Improvements of clinical symptoms, D-dimer, and pulmonary CT angiography（CTA） were observed and statistically analyzed. Results All the 30 patients had improved clinical symptoms, relieved dyspnea and chest distress, disappearance of cyanosis, and increased activity tolerance. They had relieved or disappeared lower limb swelling, normal skin temperature, reduced skin color, relieved superficial vein engorgement. After treatment, they had reduced heart rate to 75~90 times/min with sinus rhythm. Their tricuspid systolic murmur was obviously reduced, and pulmonary valves the second heart sound（P2） aortic area the second heart sound（A2）. Re-examination showed negative D-dimer, partial recanalization of pulmonary CTA, decreased pulmonary artery pressure, and 3 recovered cases to normal level. Conclusion Small dose of urokinase provide precise and safe effect in thrombolysis treatment of chronic pulmonary embolism.

关 键 词：小剂量尿激酶 溶栓 慢性肺栓塞 疗效分析 

分 类 号：R563.5[医药卫生—呼吸系统]