蚓激酶在急性中危肺血栓栓塞患者中的临床意义

目的:探讨蚓激酶在急性中危肺血栓栓塞患者治疗中的疗效及安全性.方法:回顾性分析2010年1月~2015年10月在我院住院治疗的60例急性中危肺血栓栓塞患者临床资料,依据治疗方式不同进行分组,治疗组(蚓激酶联合低分子肝素钠序贯华法林组)30例和对照组(低分子肝素钠序贯华法林组)30例,两组根据不同时期分为治疗前、治疗后10d、治疗后20d和治疗后30d亚组.比较两组治疗前、治疗后10d、20d及30d临床疗效及安全性.结果:蚓激酶组右心室最大短轴、左心室最大短轴直径、右心室最大短轴与左心室最大短轴直径比值和主肺动脉直径值在治疗后10d、20d及30d与对照组比较差异显著,且两组各亚组组间比较差异均有统计学意义.与对照组比较,蚓激酶组NT-proBNP在治疗后10d、20d和30d显著降低,而PO2值在治疗后10d、20d和30d明显升高,且对照组和蚓激酶组各亚组组间的NT-proBNP和PO2值比较差异均有统计学意义.结论:蚓激酶联合低分子肝素钠序贯华法林治疗急性中危肺血栓栓塞患者临床疗效明显且安全,值得临床推广应用.

Effect of lumbrokinase in the patients with actue moderate risk pulmonary thromboembolism

Objective To explore the curative effective and safety of lumbrokinase in the treatment of actue moderate risk pulmonary thromboembolism. Methods The clinical data of 60 patients with actue moderate risk pulmonary thromboembolism who were collected from January 2010 to October 2015 in People's hospital of hunan province was retrospectively analysed, and according to the different treatment, 60 patients with actue moderate risk pulmonary thromboembolism were randomly di-vided into the lumbrokinase group (lumbrokinase in combination with low molecular heparin and sequential warfarin) and con-trol group (low molecular heparin and sequential warfarin), each group of 30 patients. According to different periods, each group was divided into before treatment, treatment after 10 d, 20 d and 30 d subgroups, and the curative effective and safety were compared. Results Compared with control group, maxmum short axis diameter and ratio of right and left ventricles, and the main pulmonary artery diameter of lumbrokinase group were significant different in treatment after 10 d, 20 d and 30 d subgroups, and there was a statistical significance between three subgroups of the two groups. NT-proBNP of lumbrokinase group in treat-ment after 10 d, 20 d and 30 d subgroups was significantly reduced, howover, the value of PO2 was significantly increased, and there was a significant different between each other. Conclution The therapeutic method of lumbrokinase in combination with low molecular heparin and sequential warfarin in the patients with actue moderate risk pulmonary thromboembolism was clini-cal efficacy and safety, worthy of clinical popularization and application.