尿激酶对结核性胸膜炎患者的疗效及对胸膜肥厚和纤溶活性的影响

目的：研究尿激酶对结核性胸膜炎患者的疗效及对胸膜肥厚和纤溶活性的影响。方法：选择2012年9月～2014年12月在我院进行诊治的结核性胸膜炎患者106例，随机分为两组，两组抗结核化疗方案相同，均进行胸腔置管引流，观察组在胸穿抽液后注入尿激酶。分别在引流前后检测胸腔积液中组织型纤溶酶原激活物、纤溶酶原激活剂抑制因子-1和Ⅲ型前胶原，并检测胸膜厚度。结果：观察组的有效率为86.79%，明显高于对照组的69.81%；对照组治疗前后组织型纤溶酶原激活物/纤溶酶原激活剂抑制因子-1无明显变化，Ⅲ型前胶原水平明显降低，观察组的组织型纤溶酶原激活物/纤溶酶原激活剂抑制因子-1和Ⅲ型前胶原均与治疗前有明显差异，且观察组的Ⅲ型前胶原明显低于对照组；观察组的胸膜粘连发生率和胸膜厚度均明显低于对照组。结论：胸腔内注射尿激酶对结核性胸膜炎患者具有较好的疗效，能提高胸腔积液纤溶活性，减少胸膜粘连并减轻胸膜肥厚，值得应用推广。

Curative Effect of Urokinase on Patients with Tuberculous Pleurisy and its Influence on the Pleura Hypertrophy and Fibrinolytic Activity

Objective To study the curative effect of urokinase on patients with tuberculous pleurisy and its influence on the pleura hypertrophy and fibrinolytic activity. Methods Selected 106 cases of patients with tuberculous pleurisy who were treated in our hospital from September 2012 to December 2014, divided into two groups randomly. The anti-tuberculosis chem-otherapy of two groups were same, all taken the chest tube drainage, observation group after chest wear pumping liquid injection of urokinase. Respectively testing pleural effusion in the original tissue fibrinolytic enzyme activators, fibrinolytic enzyme acti-vator and inhibiting factor-1 type Ⅲ before collagen before and after drainage, and detected the pleural thickness. Results The effective rate of the observation group was 86.79%, obviously higher than that of control group 69.81%; the original tissue fibri-nolytic enzyme activation original content/fibrinolytic enzyme activator inhibitor 1 of control group had no significant change, the type Ⅲ procollagen levels significantly decreased, the original tissue fibrinolytic enzyme activation original content/fibrinolytic enzyme activator and inhibiting factor - 1 type Ⅲ procollagen the of observation group before and treatment have obvious dif-ference, and type Ⅲ procollagen of observation group was obviously lower than that of control group; the incidence of pleural adhesions and pleural thickness in observation group were significantly lower than the control group. Conclusion Chest cavity injection of urokinase in patients with tuberculous pleurisy has good curative effect, can improve the pleural effusion fibrinolytic activity, reduce pleural adhesions and lighten the pleura hypertrophy, is worth application.