摘要
目的观察注射用阿替普酶治疗高危肺栓塞的临床疗效。方法选取2010年10月—2015年10月北京市顺义区医院收治的高危肺栓塞患者66例,采用随机数字表法分为对照组和观察组,每组33例。对照组患者采用肝素冲击治疗,观察组患者采用注射用阿替普酶冲击治疗;两组患者疗程均为1周。比较两组患者治疗前后血流动力学指标、肺功能指标、凝血功能指标、呼吸功能,治疗后临床疗效及治疗期间不良反应发生情况。结果治疗前两组患者血浆黏度、全血黏度、纤维蛋白原、血细胞比容比较,差异无统计学意义(P>0.05);治疗后观察组患者血浆黏度、全血黏度、纤维蛋白原、血细胞比容低于对照组(P<0.05)。治疗前两组患者第1秒用力呼气容积(FEV_1)、用力肺活量(FVC)、FEV_1/FVC比值及6分钟步行距离比较,差异无统计学意义(P>0.05);治疗后观察组患者FEV_1、FVC、FEV_1/FVC比值高于对照组,6分钟步行距离长于对照组(P<0.05)。治疗前两组患者活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、国际标准化比值(INR)比较,差异无统计学意义(P>0.05);治疗后观察组患者APTT、PT长于对照组,INR高于对照组(P<0.05)。治疗前两组患者MRC呼吸困难量表评分比较,差异无统计学意义(P>0.05);治疗后观察组患者MRC呼吸困难量表评分低于对照组(P<0.05)。观察组患者临床疗效优于对照组(P<0.05);治疗期间两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论注射用阿替普酶治疗高危肺栓塞的临床疗效确切,能有效改善患者血流动力学、肺功能、凝血功能及呼吸功能,且安全性较高。
Objective To observe the clinical effect of aheplase for injection on high - risk pulmonary embolism. Methods From October 2010 to October 2015, a total of 66 patients with high - risk pulmonary embolism were selected in Shunyi District Hospital, Beijing, and they were divided into control group and observation group according to random number table, each of 33 cases. Patients of control group received heparin implosive therapy, while patients of observation group received alteplase for injection implosive therapy; both groups continuously treated for 1 week. Hemodynamic index, index of pulmonary function, coagulation function and respiratory function before and after treatment, clinical effect and incidence of adverse reactions were compared between the two groups. Results No statistically significant differences of plasma viscosity, whole blood viscosity, fibrinogen or hematocrit was found between the two groups before treatment （P 〉 0. 05 ） , while plasma viscosity, whole blood viscosity, fibrinogen and hematocrit of observation group were statistically significantly lower than those of control group after treatment. （P〈0.05）. No statistically significant differences of FEV1 , FVC, FEV1/FVC ratio or 6 - minute walking distance was found between the two groups before treatment （ P 〉0. 05） ; after treatment, FEV1 , FVC and FEV1/FVC ratio of observation group were statistically significantly longer than those of control group, while 6 - minute walking distance of observation group was statistically significantly longer than that of control group （ P 〈 0. 05 ）. No statistically significant differences of APTT, PT or INR was found between the two groups before treatment （ P 〉0. 05） ; after treatment, APTT and PT of observation group were statistically significantly longer than those of control group, while INR of observation group was statistically significantly higher than that of control group （P 〈 0. 05 ）. No statistically significant differences of MRC dyspnea scale score was
出处
《实用心脑肺血管病杂志》
2017年第2期117-120,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
肺栓塞
阿替普酶
治疗结果
Pulmonary embolism
Alteplase
Treatment outcome
