老年周围动脉闭塞性疾病患者血栓前状态的初步研究

目的　探讨老年周围动脉闭塞性疾病 (PAOD)患者是否存在血栓前状态 (PTS)及其临床意义。方法　检测 33例确诊为老年 PAOD患者的血浆血小板α颗粒膜蛋白 - 1 4 0 (GMP- 1 4 0 )、血管性假血友病因子 (v WF)、纤维蛋白原 (FIB)、纤溶酶原 (PLG)和 D-二聚体 (DD)以及凝血酶 -抗凝血酶 复合物 (TAT)水平 ,并分别与 40例健康老人及 30例具有心血管危险因素的非 PAOD患者进行比较。结果　老年 PAOD组的 GMP- 1 4 0(1 4 .0 6± 2 .1 8μg/ L )、DD(2 .92± 1 .3μg/ L)、v WF(1 0 4 .42 %± 31 .4%)及 FIB(60 6.8± 1 1 7.8mg/ dl)水平显著高于健康对照组 (依次为 8.2 3± 1 .86μg/ L、0 .35± 0 .1 8μg/ L、53.67%± 1 1 .33%及 2 4 2 .3± 41 .7mg/ dl) (P<0 .0 0 0 1 )和心血管危险因素组 (依次为 1 1 .97± 1 .96μg/ L、1 .0 6± 0 .53μg/L、75.8%± 4.59%及 41 3.4± 67.78mg/ dl) (P<0 .0 0 1 ) ,而 PLG活性、TAT水平各组间无显著差异。结论　老年 PAOD患者存在血栓前状态 ,且与内皮功能失调密切相关 ;积极使用抗血小板制剂和抗凝剂 ,改善血管内皮功能是 PAOD治疗的核心之一。     

他克莫司防治移植肾急性排斥反应的临床研究

目的 :研究他克莫司 (Tacrolimus ,Prograf,FK5 0 6 )在肾移植术后抗排斥反应的效果及毒副作用。　方法 :2 94例肾移植受者术后服用FK5 0 6。其中 2 6 8例在术后 2 4h即开始服用FK5 0 6 ,起始量 0 15mg/ (kg·d) ;2 6例应用环孢素A(CsA)的患者在术后 7～ 14天内出现排斥反应 ,经甲基强的松龙 (MP)冲击治疗无效后改用FK5 0 6治疗。观察FK5 0 6的治疗效果、理想的治疗窗及毒副作用。　 结果 :连续使用FK5 0 6的 2 6 8例患者中 ,肾功能 2～ 7天恢复正常者 198例 ,8～ 15天恢复正常者 4 4例 ,16～ 2 0天恢复正常者 2 1例 ,肾功能未恢复正常者 5例。发生急性排斥反应 (AR) 10 5 % (2 8/ 2 6 8) ,糖代谢紊乱 9 33% (2 5 / 2 6 8) ,神经系统功能紊乱 1 4 9% (4 / 2 6 8) ,肝功能异常 2 99%(8/ 2 6 8) ,肾中毒 1 87% (5 / 2 6 8) ,消化功能紊乱 17 5 % (4 7/ 2 6 8) ,巨细胞病毒 (CMV)血症 2 99% (8/ 2 6 8) ,肺部非CMV感染 1 4 9% (4 / 2 6 8)。脑出血死亡 0 37% (1/ 2 6 8) ,移植肾功能丧失、摘除移植肾 1 12 % (3/ 2 6 8)。FK5 0 6血药浓度为5～ 2 0 μg/L。 2 6例由CsA切换FK5 0 6治疗的耐激素性排斥反应患者中 ,有 2 3例肾功能 8～ 15天恢复正常 ,治愈率88 4 6 % (2 3/ 2 6 ) ,3例 2 8～ 32天肾功能恢     

周围动脉硬化闭塞症在老年血脂异常人群中的现患率调查

目的　了解周围动脉硬化闭塞症 (PAOD)在老年血脂异常人群中的现患率。方法　北京市万寿路地区老年居民 2 0 4 11位中 ,以家委会为单位 ,整群随机抽样抽得 2 12 4例。周围动脉硬化闭塞症的诊断以踝肱动脉压力指数(Ankle Armindex ,AAI)≤ 0 .9为标准 ;对血脂异常的诊断采用美国胆固醇教育计划 (NCEP)成人治疗第三次报告(ATPⅢ )提供的参考标准即满足下列 4条之一者为血脂异常的诊断标准 :甘油三酯 (TG)≥ 2 .2 6mmol L ,总胆固醇(TC)≥ 5 .72mmol L ,低密度脂蛋白 (LDL)≥ 3.6 4mmol L ,高密度脂蛋白 (HDL)≤ 1.0 4mmol L。结果　血脂异常患者为 10 71例 ,男 4 10例 ,女性 6 6 1例 ,年龄 6 0～ 92 (6 8.3± 5 .4 )岁 ,现患率为 5 0 .4 2 % ;其中PAOD 184例 ,现患率为17.18% ,男 6 0例 ,女 12 4例 ;PAOD在各类血脂异常患者中的患病率分别为 :高TG血症 14 .12 % ;高LDL血症10 .10 % ;高TC血症 15 .94 % ;低HDL血症 19.6 5 % ;血脂异常合并高血压患者 19.18% ;高血压患者 14 .98% ;血脂异常合并糖尿病患者 19.4 76 % ;糖尿病患者 15 .38% ;高龄血脂异常患者 4 2 .86 %。结论　HDL降低是PAOD的独立的危险因素 ;各型血脂异常对PAOD现患率的影响没有差异 ;血脂异常合并其他危险因素将明显增加PAOD的现患率 ;高     

前列地尔脂微球载体制剂治疗老年周围动脉硬化闭塞性疾病

目的　观察前列地尔脂微球制剂 (Lipo PGE1 )对老年周围动脉硬化闭塞性疾病 (PAOD)患者的临床疗效。方法　住院患者中选择Fontaine - 级 PAOD患者共 52例 ,予连续静脉滴注 Lipo PGE1 1 0μg/次 /日 ,治疗前后分别观察患者症状、踝 /肱指数、狭窄程度以及狭窄部位血流峰速等。结果　患者主观综合评分平均达 68.2 7/1 0 0分 ,35例 (67.3% )患者下肢不适症状好转 ,平均行走距离增加 1 4 8.0 4米 ,且未出现严重副作用。结论　 L ipo PGE1 可安全有效地用于老年周围动脉硬化闭塞性疾病的治疗。     

周围动脉闭塞性疾病血管内皮活性物质水平的意义

目的　探讨老年周围动脉闭塞性疾病 (peripheralarterialocclusivedisease ,PAOD)患者血管内皮活性因子水平及其临床意义。　 方法 　检测 3 3例确诊老年PAOD患者血浆一氧化氮 (NO)、内皮素 (ET)、血栓素B2(TXB2 )、6 酮 前列腺素F1α(6 K PGF1α)、P选择素 (PS)及血管性假血友病因子 (vWF) 6种血管内皮活性物质的水平 ,并分别与 40例健康老人及 3 0例具有心血管危险因素的非PAOD患者相比较。　 结果 　老年PAOD组的NO[(2 8 88± 8 54) μmol·L- 1]和 6 K PGF1α[(83 47± 13 67)ng·L- 1]水平显著低于健康老年组及心血管危险因素组 ,而ET[(95 0 9± 49 18)ng·L- 1]和TXB2 [(664 4± 3 3 1 8)ng·L- 1]、PS[(14 0 6± 2 18) μg·L- 1]及vWF[(10 4 42± 3 1 4) % ]水平显著高于健康对照组和心血管危险因素组。　结论　老年PAOD患者内皮功能失调 ;积极的控制心血管病危险因素 ,改善血管内皮功能是内科治疗PAOD的核心     

难治性肺结核51例原因分析

据国内报道 ,难治性肺结核约占肺结核者总数的 2 .4 %～4 .6 % [1 ] 。此类患者病程长 ,病情重 ,耐药率高 (约占 6 0 %～90 % ) [2 ] ,并发症多 ,疗效低 ,预后差 ,治疗稍有不当 ,死亡率高 ,是一个值得重视的问题。现将我院 1999年元月至 2 0 0 0年 12月 2年间收治的 110 8例肺结核病人中 5 1例难治肺结核的原因及疗效做一回顾性分析。临床资料1.诊断标准　均符合 1987年全国慢性传染性疾病研讨会规定 :肺结核经化疗仍排菌超过两年者。2 .性别、年龄　男 32例 ,女 19例 ;4 0岁以下者 8例 ,4 0～6 0岁者 30例 ,6 0岁以上者 13例。3.病变范围　…     

急性心肌梗塞者梗塞相关冠脉病变分析(1993～1997年病例统计)

目的 :了解急性心梗患者梗塞相关冠脉血管病变情况 ,以期明确国内急性心梗患者冠脉病变特点 ,为临床防治提供较客观的依据。方法 :从 1993年至 1997年接受冠脉造影的患者中选取在心梗急性期 (30天 )内冠造者 ,对其冠造显示的冠脉病变部位、程度及相关因素进行分析。结果 :10 4例患者纳入观察范围。年龄 2 8～ 74岁 ,平均 5 4 1± 11 4岁 ,其中男 88例 ,女 16例 ;梗塞相关冠脉狭窄程度平均为 83 3%± 16 5 % (30 %～ 10 0 % ) ,其中病变直径狭窄 <5 0 %者 5例 (4 8% ) ,5 0 %～ 6 9%者 15例(14 3% ) ,70 %～ 89%者 2 6例 (2 5 % ) ,90 %～ 99%者 35例 (33 6 % ) ,完全闭塞 (10 0 % )者 2 3例 (2 2 1% ) ;病变累及LAD者 5 3例 (5 1 0 % ) ,累及RCA者 4 2例 (40 4 % ) ,累及LCX者 9例 (8 7% ) ;纳入TUCC研究的 15例患者中LAD 10例 ,RCA4例 ,LCX 1例 ,其平均狭窄程度 92 7% (70 %～ 10 0 % )。结论 :AMI者急性期冠造仍显示有较严重的冠脉病变 ,相当一部分仍完全闭塞 ,可能与未溶栓或溶栓效果欠佳有关 ,提示应考虑急诊或补救性PTCA及冠脉支架治疗以争取较好预后     

肺转移瘤体部X刀立体定向放射治疗30例分析

目的　探讨体部 X刀立体定向放射治疗转移瘤的方法和疗效。方法　采用 CT定位 ,XKB- 1型体部 X刀立体定向放射治疗系统立体定向放疗肺转移瘤 30例 ,共计 78个病灶。病灶大小 0 .4cm～ 5 .4cm,<3cm者 5 6个 ,3cm～ 5 cm者 2 0个 ,>5 cm者2个。辐射源为 6 MVX线。单次照射剂量 3Gy～ 12 Gy,总剂量 2 0 Gy～ 48Gy。结果　肿瘤消失 12灶 (15 .4% ) ,缩小 49灶 (6 2 .8% ) ,总有效率 78.2 % ;病灶 <3cm者 ,有效率为 87.5 % ,明显高于肿瘤≥ 3cm者 (P<0 .0 1;总剂量 2 0 Gy～ 30 Gy者 ,有效率为 88% ;总剂量≤ 30 Gy组中 ,肿瘤 <3cm者的有效率高于肿瘤≥ 3cm者 (P<0 .0 1,而总剂量 >30 Gy组两者无显著差异 (P>0 .0 5 )。全组病人的1、2、3年生存率分别为 6 3.3% (19/ 30 )、34 .8% (14/ 30 )和 2 1.4% (4 / 14)。结论　体部 X刀立体定向放射治疗是治疗肺转移瘤的有效方法 ,其近期疗效与转移灶大小与照射剂量相关。     

亚甲基四氢叶酸还原酶基因多态性与原发性高血压伴周围动脉闭塞性疾病的易感性

目的　探讨北京万寿路社区老年人群亚甲基四氢叶酸还原酶 (methylenetetrahydrofolatereductase ,MTHFR)基因多态性与原发性高血压 (essentialhypertension ,EH)及EH伴周围动脉闭塞性疾病 (peripheralarterialocclusivedisease ,PAOD)的易感性。方法　用聚合酶链反应 限制性片段长度多态性技术 ,检测了 10 0例健康老年人 (NC组 )、10 0例老年EH(EH组 )及 5 9例老年EH伴PAOD患者 (EH PAOD组 )的MTHFR基因多态性。结果　MTHFR等位基因呈多态性。NC组 3种基因型频率为 :CC ,31.0 % ;CT ,5 0 .0 % ;TT ,19.0 %。EH组分别为 :CC ,2 9.0 % ;CT ,4 5 .0 % ;TT ,2 6 .0 %。EH PAOD组分别为 :CC ,15 .9% ;CT ,35 .5 % ;TT ,4 8.6 %。 3组MTHFR基因的C6 77T单核苷酸突变中T突变位点的频率分别为 4 4 .0 %、4 8.5 %、6 4 .4 %。EH PAOD组与NC组、EH PAOD组与EH组比较TT基因型频率和T等位基因频率均呈显著性差异。结论　MTHFR基因C6 77T单核苷酸突变是老年EH伴PAOD的危险因素之一 ,但可能与老年EH无关。     

急性心肌梗塞者梗塞相关冠脉脉病变分析（1993—1997年病例统计）

目的 :了解急性心梗患者梗塞相关冠脉血管病变情况 ,以期明确国内急性心梗患者冠脉病变特点 ,为临床防治提供较客观的依据。方法 :从 1993年至 1997年接受冠脉造影的患者中选取在心梗急性期 (30天 )内冠造者 ,对其冠造显示的冠脉病变部位、程度及相关因素进行分析。结果 :10 4例患者纳入观察范围。年龄 2 8～ 74岁 ,平均 5 4 1± 11 4岁 ,其中男 88例 ,女 16例 ;梗塞相关冠脉狭窄程度平均为 83 3%± 16 5 % (30 %～ 10 0 % ) ,其中病变直径狭窄 <5 0 %者 5例 (4 8% ) ,5 0 %～ 6 9%者 15例(14 3% ) ,70 %～ 89%者 2 6例 (2 5 % ) ,90 %～ 99%者 35例 (33 6 % ) ,完全闭塞 (10 0 % )者 2 3例 (2 2 1% ) ;病变累及LAD者 5 3例 (5 1 0 % ) ,累及RCA者 4 2例 (40 4 % ) ,累及LCX者 9例 (8 7% ) ;纳入TUCC研究的 15例患者中LAD 10例 ,RCA4例 ,LCX 1例 ,其平均狭窄程度 92 7% (70 %～ 10 0 % )。结论 :AMI者急性期冠造仍显示有较严重的冠脉病变 ,相当一部分仍完全闭塞 ,可能与未溶栓或溶栓效果欠佳有关 ,提示应考虑急诊或补救性PTCA及冠脉支架治疗以争取较好预后     

Study of thrombinic activation indexes, in patients with lower limb critic ischaemia, before and after prostaglandin E1 therapy.

BACKGROUND: In this study the action of a prostaglandin, PGE1, was studied in a group of patients with peripheral arterial occlusive disease (PAOD). METHODS: In 16 patients (14 men and 2 women, aged 47-70 years, mean 57 +/- 7) with PAOD, Fontaine stage IIb and III in critical ischemia, the effects on two indexes of thrombin generation and action of the endovenous administration (2 hours) of 60 micrograms of Alprostadil-PGE1 for four weeks were evaluated. In all artheriopathic patients, before and after pharmacological treatment, the following haemostatic parameters were evaluated: the prothrombin fragment 1 + 2 (F1 + 2) and the fibrinopeptide A(FPA). RESULTS: The patients showed plasma levels of FPA significantly decreased at the end of the treatment. On the other hand, no significant difference in plasma F1 + 2 levels was observed after treatment. CONCLUSIONS: These results seem to indicate that plasma F1 + 2 levels are significantly elevated, as a marker of thrombosis status, in patients with PAOD before and after treatment with PGE1.     

Intravenous prostaglandin E1 reduces monocyte chemoattractant protein-1 levels in peripheral arterial obstructive disease

Objectives Blood monocytes are the precursors of the lipid-laden foam cells that are the hallmark of early atherosclerotic lesions, and monocyte chemoattractant protein-1 (MCP-1) plays important roles in their recruitment to the vessel wall. In this study, we measured serum levels of MCP-1 in patients with peripheral arterial obstructive disease (PAOD) and investigated whether intravenous prostaglandin E1 (PGE1) treatment, which produces clinical benefits in PAOD, might decrease such levels. Methods Eight patients with PAOD at Fontaine stage II to IV were treated with a daily intravenous infusion of 10 μg of PGE1 for 7 consecutive days. Blood samples before and after 7-day PGE1 treatment were used for assays of MCP-1, interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), von Willebrand factor (vWF), and endothelin-1 (ET-1). Results Serum MCP-1 levels in patients with PAOD were significantly higher than those in healthy control subjects (263.8 ± 52.8 vs 136.5 ± 15.0 pg/mL, P = .002). PGE1 administration for 7 days resulted in a significant decrease in the MCP-1 level, from 263.8 ± 52.8 to 196.1 ± 25.5 pg/mL (P = .02), whereas levels of IL-6, hs-CRP, and ET-1 and the activity of vWF were not affected. Conclusions Serum MCP-1 levels were elevated in patients with PAOD, indicating the involvement of activation of monocytes in the pathogenesis of this disorder. Parenteral administration of PGE1 appeared to decrease circulating MCP-1 levels, which might lead to the suppression of the development of atherosclerotic lesions in patients with PAOD. (Am Heart J 2003;145:330-3.)     

Cost-utility Analysis of Treating Severe Peripheral Arterial Occlusive Disease

The importance of economic analysis in public health constantly increases due to the persistent debate on restricted resources. The treatment of peripheral arterial occlusive disease (PAOD) in its severe stages is the object of this health economic evaluation. The disease course of patients with severe PAOD is simulated in a Markov model according to the available treatment options: prostaglandin El, percutaneous transluminal angioplasty and bypass. Long-term treatment strategies are composed of two therapy options. The expected costs from societal perspective, life expectancy and quality of life are included in a cost-utility analysis. The remaining life expectancy of a patient in the stage III/IV (aged 65–75 years) is maximized by the repeated use of bypass on average of 4.7 years. Considering quality of life, this therapy strategy can provide the best results with 2.92 QALY. Repeated infusion of PGE1 is cost-effective with 4,944.19€/QALY. The results are analyzed in a sensitivity analysis. Considering cost-effectiveness, conservative interventions for treating patients with PAOD in severe stages must be taken into account. Further data about competitive cost-effectiveness of the alternative therapy options is necessary for a valid estimation of costs and quality of life in patients with PAOD.     

Neutralization of prostaglandin E1 intravenous solution reduces infusion phlebitis

Previous studies have shown moderate or severe phlebitis at the site of venipuncture in some patients who receiving prostaglandin E1 (PGE1) infusion therapy. Such phlebitis is sometimes severe enough to necessitate the cessation of PGE1 therapy. This study investigated how to continue PGE1 infusion therapy for 3 weeks with tolerable phlebitis. Although a 60 microg dose of PGE1 is usually dissolved in 500 mL of fluid to avoid phlebitis, we used 200 mL to prevent volume overload. This PGE1 solution was neutralized to pH 7.4 with 4 mL of 7% sodium bicarbonate. We examined the frequency and severity of phlebitis among patients who received a 2-h PGE1 infusion twice daily. Eighteen patients who were hospitalized for peripheral vascular disease between June 1998 and May 1999 were studied. All of them were men and their mean age was 63.3 +/- 8.9 years (range: 47-78 years). Fourteen patients had arteriosclerosis obliterans and four had Buerger's disease. When the severity of phlebitis was determined according to Dinley's criteria, two patients (11%) had grade 0, four patients (22%) had grade 1, eleven patients (61%) had grade 2, and one patient (6%) had grade 3 phlebitis. Usually, PGE1 infusion therapy is stopped when phlebitis reaches grade 4 or more, but there were no such cases in this study. We also found that aging was significantly correlated with a decrease in the severity of phlebitis (Spearman's rank correlation test: r = -0.545, p = 0.0193).     

New aspects of prostaglandin E1 therapeutic influence in thrombo-angiitis obliterans

Prostaglandin E1 because of its unique protective and repaired endothelial action is used in the treatment of many diseases. The aim of the study was the investigation of prostaglandin E1 influence on some adhesive molecules profile in the patients with thrombangitis obliterans. 21 patients, aged 31-49 years (mean 40.3 +/- 5.3), with thrombangitis obliterans were observed. The control group consisted of 22 healthy patients, aged 18-50 years (mean 34.6 +/- 12.25 years). In both groups as well the number of circulated endothelial cells and selectin L, P, E and vWF factor concentration were measured. In patients suffered from thrombangitis obliterans these parameters were measured before and after 21 days intraarterial 10 mg PGE1 (Alprostadil) infusion. No PGE1 influence on selectin E concentration was observed, the mean values as well before as after the treatment were equal to 66.56 +/- 8.92 ng/ml. The decrease in selectin P concentration was observed but the difference was not statistically significant. The statistically significant reduction was observed in selectin L (decrease from 799.88 +/- 104.79 ng/ml to 764.83 +/- 116.04 ng/ml) and vWF concentration (decrease from 195.04% +/- 26.2% to 187.69% +/- 22.83%). The final PGE1 therapeutic result was the circulating endothelial cells decrease (from 2.47 +/- 1.01 before to 2.36 +/- 0.97 cells/ml after treatment). Intraarterial PGE1 infusion in patients with thrombangitis obliterans results in significant selectin L, vWF factor concentration decrease less; this decrease is less marked in selectin P concentration. As the inhibition of the adhesive molecules activation effect the number of exfoliated circulated endothelial cells decrease is observed.     

Mechanisms of action of prostaglandin E1 in therapy of peripheral arterial occlusive diseases

Mode of action of prostaglandin E1 in the treatment of peripheral arterial disease. Prostaglandin E1 has been used for the first time in the treatment of peripheral arterial occlusive disease 30 years ago. Although widely used, the exact mechanism of the known beneficial effects is not completely understood. A strong vasodilation is induced after intra-arterial administration of PGE1, but is not seen, when PGE1 is intravenously infused. Because of the clinical efficacy of intravenously given PGE1, vasodilation is not considered as important mode of action. Many effects of PGE1 has been described on cellular factors in the blood, hemostasis and fibrinolysis and endothelium. Some of these effects are discussed.     

前列腺素E1抗肝纤维化的临床疗效观察

目的：观察前列腺素E1对活动性肝炎肝硬化的抗纤维化疗效。方法将100例患者随机分为两组,治疗组50例以PGE160μ g加入10T葡萄糖250ml中静滴,1次／d,疗程30d。对照组以门冬氨酸钾镁30ml加入10％葡萄糖中250ml静滴,1次／d,疗程相同。两组患者性别、年龄和肝功能均有可比性。治疗前后以放射免疫法检测血清HA、IVC、LN,B超探测脾脏厚度。结果治疗组血清HA、IVC以及LN水平明显降低,与治疗前及对照组相比较差异有非常显著性（P＜0．01）,治疗组50％病例脾脏缩小。结论PGE1能明显降低肝炎肝硬化患者血清HA、IVC、LN水平,且脾脏缩小,有一定抗纤维化作用。可作为抗纤维化的治疗药物。     

Effects of exogenous prostaglandin E1 in hepatectomized patients

The efficacy of prostaglandin E1 (PGE1) in preventing hepatic failure after hepatectomy was investigated prospectively in eight PGE1-treated patients and in seven untreated controls. The patients in the PGE1-treated group received PGE1 (0.03 μg/kg per min) intravenously for 72 h beginning at the initiation of surgery. The cardiac index increased markedly and the systemic vascular resistance decreased markedly during PGE1 treatment, while no significant changes were observed in the control group. The platelet count in the PGE1-treated group decreased slightly, while that in the control group decreased significantly during the first 3 postoperative days. The percent change of alanine aminotranferase in the PGE1-treated group was less than that in the control group. These findings suggest that the administration of exogenous PGE1 following hepatectomy increases hepatic blood flow and suppresses platelet aggregation, and therefore may be cytoprotective to the remnant liver. Thus, PGE1 may be effective in preventing hepatic failure after hepatectomy.     

肝素联合前列腺素E1治疗下肢深静脉血栓形成的研究

目的:观察普通肝素联合前列腺素E1在治疗下肢深静脉血栓形成(DVT)中的作用。方法:下肢DVT患者17例,分为治疗组9例,对照组8例;治疗组由普通肝素联合前列腺素E1及常规治疗,对照组为低分子量肝素及常规治疗。治疗1、7 d后检测下肢血流、纤维蛋白原、D-二聚体及疼痛及肢体肿胀情况。结果:治疗1 d后,2组患者肢体疼痛及肢体肿胀情况较治疗前趋向改善,但所有指标2组比较均差异无统计学意义;治疗7 d后,治疗组较对照组下肢血流情况明显改善(P<0.05),纤维蛋白原下降明显(P<0.05)。结论:普通肝素联合前列腺素E1治疗下肢DVT可能较单一运用低分子肝素效果为佳,且安全性亦好。