摘要
目的探讨重组组织型纤溶酶原激活剂（rt-PA）用于下腔静脉血栓溶栓治疗的有效性及安全性。方法北京积水潭医院血管外科2009年12月至2012年12月间收治急性下腔静脉血栓形成患者90例，经医院伦理委员会审核通过，数字随机分成2组，一组为溶栓＋抗凝治疗，一组为单纯抗凝治疗。2周后检测D-二聚体、纤维蛋白原及纤维蛋白降解产物变化，同时观察有无并发症发生。结果溶栓＋抗凝组治疗前D-二聚体、FIB和FDP分别为13．9±8．7、427．4±71．2和18．1±8．7，治疗2周后复查结果分别为3．2±2．0、269．9．±63．6和5．4±3．5，治疗前后差异均有统计学意义（均P〈0．05）。单纯抗凝组治疗前D-二聚体、FIB和FDP分别为9．2±7．8、373．8±99．7和23．5±25．9，治疗2周后复查结果分别为7．4±7．1、335．9±85．9和14．8±15．0，治疗前后FIB和FDP的差异有统计学意义（P〈0．05）。2组患者治疗前化验指标无统计学差异，治疗后溶栓＋抗凝组各项指标下降的更为显著（P〈0．05）。研究中发生大出血1例（溶栓＋抗凝组），溶栓＋抗凝组发生小出血3例（6．7％），单纯抗凝组1例（2．2％），两组出血事件差异无统计学意义。结论与单纯抗凝相比，加用重组组织型纤溶酶原激活剂溶栓对下腔静脉血栓的治疗更有效，且两种治疗的安全性相近。
Objective To explore the efficacy and safety of recombinant tissue plasminogen activator （rt-PA） in thrombolytic therapy of vena caval thromboembolism. Methods Ninety patients diagnosed of vena caval thromboembolism by ultrasound or angiography of infernal vena cava were randomly assigned into 2 groups, rt-PA and parental anticoagulant were given to the patients in the treatment group while those in the control group received only parental anticoagulation. D-dimer, fibrinogen and fibrinogen degradation product were analyzed after 2-week treatment. All subjects were closely monitored for the occurrence of severe complications. Results The changes from baseline in the above laboratory parameters in the treatment group were significantly greater than those of the control group （ P 〈 0. 05 ）. No severe complications occurred in either group. Conclusion rt-PA is both safe and effective for the thrombolytic therapy of vena caval thromboembolism.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第47期3783-3785,共3页
National Medical Journal of China
关键词
下腔静脉血栓
重组组织型纤溶酶原激活剂
溶栓治疗
Vena caval thromboembolism
Recombinant tissue plasminogen activator
Thrombolytic therapy
