摘要
目的:探讨阿替普酶联合抗凝治疗高危急性肺栓塞的疗效及对血清凝血因子(Ⅹa)水平的影响。方法:106例高危急性肺栓塞患者随机分为观察组(n=55)和对照组(n=51)。对照组使用尿激酶联合抗凝治疗,观察组采用阿替普酶联合抗凝治疗。比较两组治疗前后内皮素1(ET-1)、Ⅹa、每分通气量(VE)、血氧饱和度(SpO_2)、潮气量(VT)、呼气末二氧化碳分压(P_(E-T)CO_2)水平变化,观察两组临床症状消失时间、疗效及药品不良反应发生情况。结果:观察组总有效率为92.73%,明显高于对照组的70.59%(P<0.05);临床症状消失时间显著低于对照组(P<0.05)。治疗后,两组患者的ET-1、Ⅹa水平和P_(E-T) CO_2水平均较前明显下降;VE、SpO_2及VT水平则较前升高(P<0.05);且观察组患者ET-1、Ⅹa、P_(E-T)CO_2水平显著低于对照组,VE、SpO_2及VT水平均显著高于对照组(P<0.05)。观察组药品不良反应发生率为9.09%,显著低于对照组(P<0.05)。结论:阿替普酶联合抗凝治疗高危急性肺栓塞效果显著,明显优于尿激酶联合抗凝治疗的患者,可能与其有效改善血清Ⅹa因子及改善肺通气功能有关。
Objective: To study the curative efficacy of alteplase combined with anticoagulation in the treatment of high risk acute pulmonary embolism and its effects on the serum level of Ⅹa factor. Methods: Totally 106 patients with high risk acute pulmonary embolism were selected,and divided into the observation group( n = 55) and the control group( n = 51) according to the randomized table. The control group was treated with urokinase combined with anticoagulation therapy. The observation group was treated with atreptase combined with the same anticoagulation therapy. Atreptase 50 mg was dissolved in 50 ml 0. 9% sodium chloride injection,which was pumped by a micropump within 2 h. The changes of endothelin 1( ET-1),Ⅹa,clinical symptoms disappearance time,a minute ventilation( VE),blood oxygen saturation( SpO2),tidal volume( VT),carbon dioxide partial pressure at the end of exhalation( PE-TCO2) and adverse reactions in the two groups before and after the treatment were compared. Results: After the treatment,the total effective rate of the observation group was 92. 73%,which was higher than that( 70. 59%) of the control group( P < 0. 05),and the clinical symptoms disappearance time was significantly shorter than that in the control group( P < 0. 05). The levels of ET-1,Ⅹa and PE-TCO2 in the two groups were notably decreased after the treatment,and the levels of VE,SpO2 and VT in the two groups were significantly higher than those before the treatment( P < 0. 05),and the changes in the observation group were more significant than those in the control group( P < 0. 05). The incidence of adverse reactions was 9. 09% in the observation group,which was significantly lower than that in the control group( P < 0. 05). Conclusion: Alteplase combined with anticoagulation in the treatment of high risk acute pulmonary embolism is remarkable,which is superior to urokinase combined with anticoagulant therapy,and related to the notable improvement of serum Ⅹa factor and pulmonary ventilation function.
作者
白文梅
王兵
罗建江
Bai Wenmei;Wang Bing;Luo Jianjiang(Department of Respiration, Affiliated Hospital of Trad迅onal Chinese Medicine, Xinjiang MedicalUniversity, Urumqi 830000, China)
出处
《中国药师》
CAS
2019年第4期690-692,共3页
China Pharmacist
关键词
阿替普酶
尿激酶
低分子肝素
利伐沙班
高危
急性肺栓塞
凝血因子
Alteplase
Urokinase
Low molecular weight heparin
Rivaroxaban
High risk
Acute pulmonary embolism
Clotting factor
