局部溶栓加抗凝对急性肺栓塞性肺高压的疗效观察

目的　研究经导管肺动脉局部溶栓加抗凝治疗在急性肺栓塞性肺动脉高压的作用。方法　2 0只小猪自体血栓注入建立急性肺栓塞性肺动脉高压模型。随机分2组,经导管肺动脉局部溶栓加抗凝(A组10只)、局部溶栓不加抗凝(B组10只)。溶栓前、溶栓后2h测肺动脉收缩压(SPAP)、股动脉收缩血压(SABP)、心率(HR)、心输出量(CI)、血气分析(PaO2 、PaCO2 、pH)、纤溶酶 抗纤溶酶复合物(PAP)、DD二聚体(DD)、一氧化氮(NO)。结果　两组SPAP、CI、PaO2 、PaCO2 、PAP、DD、NO均较治疗前有显著变化(P <0 0 5 ) ,A组的SPAP、PAP的变化较B组的变化更显著(P <0 .0 5 )。结论　肺栓塞治疗中,局部溶栓加抗凝的疗效优于单纯局部溶栓。

Local Thrombolysis and Anticoagulation in the Treatment of Acute Thromboembolic Pulmonary Hypertension

Objective To investigate local thrombolysis and anticoagulation by catheter in the treatment of acute thromboembolic pulmonary hypertension.Methods An animal model of acute pulmonary embolism was established by intravenous infusion of autologous blood clot.20 model pigs were randomly assigned to receive local thrombolytic and anticoagulation therapy(A,n=10) or local thrombolytic therapy without anticoagulation(B,n=10).Systolic pulmonary artery pressure(SPAP)?systolic artery blood pressure(SABP)?cardiac index(CI)?heart rate(HR)?blood gas analysis?nitric oxide(NO)?D-dimer(DD)?plasmin-antiplasmin(PAP) were measured respectively before treatment and 2 hours after treatment.Results SPAP?CI?PaO_2?PaCO_2?PAP?DD?NO chanaed significantly after thrombolysis in two groups(P<0.05).To compare with group B,SPAP?PAP had changed more significantly in group A(P<0.05).Conclusion Local thrombolysis and anticoagulation by catheter was more effective in the treatment of acute thromboembolic pulmonary hypertension.