摘要
目的对比重组人尿激酶原与尿激酶在下肢深静脉血栓溶栓治疗中的疗效。方法回顾性分析内蒙古医科大学附属医院2016年9月至2017年3月单侧下肢深静脉血栓行溶栓治疗51病例临床资料,其中用重组人尿激酶原溶栓治疗19例(重组人尿激酶原组),尿激酶溶栓治疗32例(尿激酶组)。所有患者先行下腔静脉滤器植入术后,经患肢腘静脉途径置入溶栓导管溶栓、抗凝治疗。溶栓治疗后比较两组的再通畅率、患肢与健肢周径差值及不良反应发生情况。结果重组人尿激酶原组再通畅16例,再通畅率为84.2%;尿激酶组再通畅18例,再通畅率为56.25%。重组人尿激酶组再通畅率明显高于尿激酶组(P<0.05)。重组人尿激酶原组溶栓治疗前后大腿周径差值为4.3±1.9cm;小腿周径差值2.6±0.6 cm。尿激酶组溶栓治疗前后大腿周径差值2.5±1.4 cm;小腿周径差值2.2±0.4 cm。重组人尿激酶原组大腿、小腿周径差值均明显高于尿激酶组(P<0.05)。重组人尿激酶原组发生出血等不良反应2例,尿激酶组出现11例出血、1例心律失常不良反应;重组人尿激酶原组不良反应发生率(10.5%)明显低于尿激酶组(37.5%),差异有显著性(P<0.05)。结论下肢深静脉血栓溶栓治疗中重组人尿激酶原溶栓疗效明显优于尿激酶。
Objective To compare the efficacy of recombinant prourokinase and urokinase in treatment of lower extremity deep venous thrombosis. Methods The clinical data of 51 patients with deep venous thrombosis in lower extremity of this hospital during September, 2016 to March, 2017 were retrospectively analyzed. Among them, 19 patients were treated with recombinant prourokinase, and 32 patients were treated with urokinase, under the protection of inferior vena cava filter, all these patients were treated by catheter directed thrombosis through the popliteal vein continuous infusion. After thrombolytic therapy, the patency rate of these two groups had been compared, and the difference between limb and circumference of limb and the incidence of adverse reactions had been compared. Results The reperfusion after treatment in recombinant prou- rokinase group was occurred in 16 eases, and that in urokinase group was 18 cases. The lower extremity deep venous reperfusion rate with recombi- nant prourokinase was 84.2%, it was significantly higher than 56.3% of urokinase group （ P 〈 0.05 ）. In recombinant prourokinase group, the circumferences in uninjured side and diseased side of thigh and calf after treatment were 4.3 ± 1.9 cm and 2.6± 0.6 cm respectively, but in uro- kinase group, the circumferences of uninjured side and diseased side thigh and calf after treatment were 2.5 ± 1.4 cm and 2.2 ± 0.4 cm rspective- ly. In observation group, the circumferences of uninjured side and diseased side of thigh and calf after treatment were significantly higher than those of control group （ P 〈 0.05 ）. Bleeding and other adverse reactions occurred in 2 cases of recombinant prourokinase group, bleeding oc- curred in 11 cases and arrhythmia in 1 case of urokinase group. The incidence rates of adverse reactions in these 2 groups were 10.5% and 37.5% respectively, and the difference between these 2 groups was significant （ P 〈 0.05 ）. Conclusion The therapeutic effect of recombinant prouroki- nase on lower extremity deep venous thmnlbosis is better than urokinase.
出处
《临床和实验医学杂志》
2017年第17期1736-1739,共4页
Journal of Clinical and Experimental Medicine
关键词
下肢深静脉血栓
重组人尿激酶原
尿激酶
溶栓治疗
Lower extremity deep venolls thmnlbosis
Recombinant prourokinase
Urokinase
Thrombosis
