摘要
目的探讨重组人尿激酶原在急性肺栓塞(APE)治疗中的疗效及安全性。方法选取2015年9月至2016年8月我院收治的APE患者78例,根据患者入院顺序分为观察组和对照组,每组各39例。观察组静脉用重组人尿激酶原,对照组静脉滴注尿激酶。计算两组患者临床总有效率,比较两组患者治疗前、后血气、血压、凝血及纤溶相关指标,并观察两组患者不良反应发生情况。结果治疗后,观察组总有效率高于对照组[89.74%对61.54%,P<0.05)。与治疗前相比,两组治疗后血气、血压、凝血及纤溶相关指标均较治疗前有所改善(P<0.01),其中观察组动脉血氧分压、收缩压水平高于对照组[(88.96±8.43)mm Hg、(132.98±14.65)mm Hg对(78.98±7.87)mm Hg、(122.97±12.89)mm Hg](P<0.05或P<0.01),肺动脉收缩压低于对照组[(32.98±3.84)mm Hg对(45.98±4.87)mm Hg](P<0.01);观察组纤溶酶原激活物、纤溶酶原激活物抑制物-1、凝血调节蛋白、血浆蛋白C、血浆蛋白S、血浆D-二聚体水平均低于对照组[(6.04±0.61)μg/L、(48.21±4.25)μg/L、(3.51±0.32)μg/L、(2.14±0.26)mg/L、(13.56±1.46)mg/L、(0.72±0.04)mg/L对(9.87±0.93)μg/L、(54.32±5.11)μg/L、(5.15±0.53)μg/L、(3.24±0.37)mg/L、(19.58±1.94)mg/L、(1.03±0.09)mg/L](P<0.01)。观察组不良反应发生率低于对照组(7.69%对35.90%)(P<0.05)。结论重组人尿激酶原治疗APE临床疗效好,能有效改善患者血气、血压、凝血及纤溶相关指标,出血等不良反应少,值得临床推广应用。
Objective To study the efficacy and safety of recombinant human prourokinase in the treatment of acute pulmonary embolism（APE）. Methods A total of 78 cases of APE patients from September 2015 to August 2016 admitted were divided into observation group and control group according to the order of admission. The observation group was received recombinant human prourokinase, and the control group was given urokinase for treatment. The total effective rates of the two groups were calculated, and the blood gas, blood pressure, coagulation and the fibrinolysis related indexes of two groups before and after treatment were compared. The incidences of adverse drug reactions in two groups were observed. Results After treatment, the total effective rate of the observation group was higher than that of the control group（89.74% vs 61.54%, P〈0.05）. Compared with before treatment, the blood gas, blood pressure, coagulation and the fibrinolysis related indexes of two groups after treatment were improved（P〈0.01）. The arterial oxygen pressure and systolic blood pressure in observation group were higher than those in control group [（88.96±8.43） mm Hg,（132.98±14.65） mm Hg vs（78.98±7.87） mm Hg,（122.97±12.89） mm Hg]（P〈0.05, P〈0.01）, and the pulmonary artery systolic pressure was lower than that of control group [（32.98±3.84） mm Hg vs（45.98±4.87）mm Hg]（P〈0.01）. The tissue type plasminogen activator, plasminogen activator inhibitor-1, coagulation regulator protein, protein C, protein S, plasma D-dimer（DD） in observation group were lower than those in control group [（6.04±0.61） μg/L,（48.21±4.25） μg/L,（3.51±0.32） μg/L,（2.14±0.26） mg/L（13.56±1.46） mg/L, and（0.72±0.04） mg/L vs（9.87±0.93） μg/L,（54.32±5.11） μg/L,（5.15±0.53） μg/L,（3.24±0.37） mg/L,（19.58±1.94） mg/L, and（1.03±0.09） mg/L]（P〈0.01）. The adverse drug reaction rate in observation group was lower than that in control group（7.69% vs 35.90%, P〈0.05�
作者
张琴琴
梁宗安
秦先梅
ZHANG Qin-qin1,2, LIANG Zong-an1, QIN Xian-mei2(1. Department of Respiratory and Critical Medical West China School of Medicine~West China Hospital Sichuan University, Chengdu 610041; 2. Department of Respiratory Medicine, Yongehuan Hospital of Chongqing Medical University, Chongqing 402160, Chin)
出处
《世界临床药物》
CAS
2018年第5期313-317,共5页
World Clinical Drug
关键词
重组人尿激酶原
急性肺栓塞(APE)
疗效
不良反应
recombinant human prourokinase
acute pulmonary embolism （APE）
curative effect
adverse drug reaction
