瑞替普酶与尿激酶在髂股静脉血栓导管溶栓中的疗效比较  

Comparison of efficacy of reteplase and urokinase in the catheter-directed thrombolysis for iliofemoral venous thrombosis

作　　者：王恒振 魏争[1] 邹卿云 张博健 刘冰[1] Wang Hengzhen;Wei Zheng;Zou Qingyun;Zhang Bojian;Liu Bing(Department of Vascular Surgery,The First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院血管外科,哈尔滨150001

出　　处：《中国血管外科杂志（电子版）》2020年第4期292-295,共4页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的比较瑞替普酶(reteplase,rPA)与尿激酶(urokinase,UK)在CDT治疗髂股静脉血栓形成的疗效。方法回顾性分析2018年1月至2019年12月哈尔滨医科大学附属第一医院153例行CDT的髂股静脉血栓患者资料,其中使用rPA溶栓59例(rPA组),使用UK溶栓94例(UK组),对比两组患者在溶栓结果相关指标的差异。结果rPA组和UK组相比,溶栓时间更短(5.13±2.29)d vs(7.26±3.74)d,P<0.001,住院时间短(7.02±1.99)d vs(9.21±3.10)d,P<0.001,但费用相对较高(2537.00±566.26)元vs(975.00±262.31)元,P<0.001。两组并发症发生率差异无统计学意义(25.42%vs 23.40%,P=0.606),但rPA组一期复通率较高(62.07%vs 40.26%,P=0.043),且血栓溶解达到Ⅲ级的比例明显高于UK组(54.38%vs 30.34%,P=0.013)。结论rPA在CDT治疗髂股静脉血栓形成的安全性和UK相似,且溶栓效果优于UK,可明显缩短住院时间。Objective To compare the efficacy of reteplase(rPA)and urokinase(UK)in the catheter-directed thrombolysis(CDT)for iliofemoral venous thrombosis.Methods The clinical data of 153 patients with iliac femoral vein thrombosis underwent CDT from January 2018 to December 2019 in the First Affiliated Hospital of Harbin Medical University were analyzed retrospectively.Among them,59 cases were treated with rPA(rPA group)and 94 cases were treated with UK(UK group).Thrombolysis results between the two groups were compared.Results Compared with the UK group,the rPA group had shorter thrombolysis time(5.13±2.29)d vs(7.26±3.74)d,P<0.001,and shorter hospital stay(7.02±1.99)d vs(9.21±3.10)d,P<0.001,but the cost is relatively higher(2537.00±566.26)yuan vs(975.00±262.31)yuan,P<0.001.There was no significant difference in the incidence of complications between the two groups(25.42%vs 23.40%,P=0.606).The first-stage recanalization rate in the rPA group was higher(62.07%vs 40.26%,P=0.043),and thrombolytic effect of gradeⅢwas significantly higher than UK group(54.38%vs 30.34%,P=0.013).Conclusion The safety of rPA in the CDT for iliofemoral venous thrombosis is similar to UK,and the thrombolytic effect is better,which can significantly shorten the hospital stay.

关 键 词：髂股静脉血栓 溶栓 瑞替普酶 尿激酶 

分 类 号：R543.6[医药卫生—心血管疾病]