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[蚓激酶对急性中度风险肺血栓栓塞症患者的影响]

[Effect of lumbrokinase on patients with acute and moderate risk pulmonary thromboembolism].

作者信息

Jiang Gang, Zhang Weidong, Peng Minlian, Yan Wenguang

机构信息

Department of Respiratory Medicine, Hunan Provincial People's Hospital, Changsha 410005, China

Department of Respiratory Medicine, Hunan Provincial People's Hospital, Changsha 410005, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2017 Oct 28;42(10):1156-1162. doi: 10.11817/j.issn.1672-7347.2017.10.005.

Abstract

To explore the clinical efficacy and safety of lumbrokinase in the treatment of acute and moderate risk pulmonary thromboembolism.
 Methods: The clinical data of 60 patients with acute and moderate risk pulmonary thromboembolism, who were collected from January 2010 to October 2015 in Hunan Provincial People's Hospital, were retrospectively analyzed. According to the different treatments, 60 patients were randomly divided into a lumbrokinase group (lumbrokinase in combination with low molecular heparin and sequential warfarin, n=30) and a control group (low molecular heparin and sequential warfarin, n=30). The clinical efficacy and safety were compared between the two groups.
 Results: Compared with the control group, maximum short axis, ratio of right and left ventricles, systolic pulmonary artery pressure, and the main pulmonary artery diameter in the lumbrokinase group were significant changed after the treatment for 10, 20 and 30 d. NT-proBNP level in the lumbrokinase group after the treatment for 10, 20 and 30 d was significantly reduced than that in the the control group (P<0.05). However, the value of PO2 significantly increased after 10, 20 and 30 d, and there was no significant difference between 20 d and 30 d (P>0.05). D-dimer in the two groups was obviously increased after treatment for 10 d, but it was significantly reduced after treatment for 20 d or 30 d (P<0.05). The clinical efficacy of the lumbrokinase group was better than that in the control group, with significant difference (P<0.05).
 Conclusion: Combination of lumbrokinase with low molecular heparin and sequential warfarin is a safe and efficient strategy in treating the patients with acute and moderate risk pulmonary thromboembolism. It is worthy of clinical popularization and application.

摘要

探讨蚓激酶治疗急性中危肺血栓栓塞症的临床疗效及安全性。方法:回顾性分析2010年1月至2015年10月在湖南省人民医院收集的60例急性中危肺血栓栓塞症患者的临床资料。根据治疗方法不同,将60例患者随机分为蚓激酶组(蚓激酶联合低分子肝素及序贯华法林,n = 30)和对照组(低分子肝素及序贯华法林,n = 30)。比较两组的临床疗效及安全性。结果:与对照组相比,蚓激酶组治疗10、20及30 d后最大短轴、左右心室比值、收缩期肺动脉压及主肺动脉直径均有显著变化。蚓激酶组治疗10、20及30 d后的NT-proBNP水平明显低于对照组(P<0.05)。然而,治疗10、20及30 d后PO2值明显升高,20 d与30 d之间无显著差异(P>0.05)。两组治疗10 d后D-二聚体明显升高,但治疗20 d或30 d后明显降低(P<0.05)。蚓激酶组的临床疗效优于对照组,差异有统计学意义(P<0.05)。结论:蚓激酶联合低分子肝素及序贯华法林治疗急性中危肺血栓栓塞症患者是一种安全有效的策略,值得临床推广应用。

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