导管碎栓联合溶栓治疗减轻急性肺动脉栓塞患者氧化应激反应  

Catheter-directed thrombolysis combined with thrombolytic therapy alleviates oxidative stress in patients with acute pulmonary embolism

作　　者：冉继朋[1] 刘子腾[1] 张莎莎 张静波[1] RAN Ji-peng;LIU Zi-teng;ZHANG Sha-sha;ZHANG Jing-bo(Department of Cardiovascular Surgery,Baoding No.1 Central Hospital,Hebei Baoding 071000,China)

机构地区：[1]保定市第一中心医院心脏血管外科,河北保定071000

出　　处：《内科急危重症杂志》2023年第5期402-405,416,共5页Journal of Critical Care In Internal Medicine

基　　金：河北省保定市科学技术局项目(No:18ZF323)。

摘　　要：目的:探究导管碎栓联合溶栓治疗急性肺动脉栓塞(APE)患者的疗效及其对氧化应激反应的影响。方法:选取高危APE患者186例,采用随机抽签法分为传统溶栓组和导管溶栓组,每组93例。传统溶栓组采用尿激酶传统溶栓治疗,导管溶栓组采用猪尾导管联合溶栓治疗。观察2组患者血气、血流动力学、氧化应激反应指标、临床症状缓解时间及疗效。结果:治疗14 d后,导管溶栓组血流动力学、丙二醛(MDA)、平均肺动脉压、B型脑钠肽(BNP)、肌钙蛋白I(cTnI)水平低于传统溶栓组,右心房直径小于传统溶栓组,症状缓解时间明显短于传统溶栓组,血气指标、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-px)水平、治疗总有效率高于传统溶栓组(P均<0.05)。结论:导管碎栓联合溶栓治疗可有效降低APE患者MDA水平,上调SOD及GSH-px水平,减轻机体氧化应激反应,有效缓解患者临床症状。Objective:To investigate the effect of catheter-directed thrombolysis and thrombolysis in acute pulmonary embolism(APE)and on oxidative stress.Methods:A total of 186 high-risk patients with APE were selected and randomly divided into the traditional thrombolysis group and catheter-directed thrombolysis group,with 93 patients in each group.The traditional thrombolysis group received urokinase-based conventional thrombolysis treatment,and the catheter-directed thrombolysis group was treated with pigtail catheter and thrombolysis.Blood gas parameters,hemodynamics,oxidative stress response indexes,clinical symptom remission time and clinical efficacy were observed.Results:After 14 days of treatment,the catheter-directed thrombolysis group showed better hemodynamics,lower malondialdehyde,right atrial diameter,mean pulmonary artery pressure,BNP index,and cTnI index than those of traditional thrombolysis group(P<0.05).Blood gas parameters,levels of superoxide dismutase and glutathione peroxidase in the catheter-directed thrombolysis group were higher,and the overall treatment was significantly efficient compared to those in the traditional thrombolysis group(P<0.05).The remission time for symptoms in the catheter-directed thrombolysis group was significantly shorter than that in the conventional thrombolysis group(P<0.05).Conclusion:Catheter-directed therapy combined with thrombolysis can effectively reduce malondialdehyde,increase the level of superoxidase dismutase and glutathione peroxidase,and decrease the body's oxidative stress response,thus effectively relieving clinical symptoms and improving the overall treatment efficiency.

关 键 词：导管碎栓 溶栓治疗 急性肺动脉栓塞 氧化应激反应 

分 类 号：R543.2[医药卫生—心血管疾病]