CAJ | 학술논문

目的：观察注射用纤溶酶联合低分子肝素钙治疗肺栓塞易栓因素患者的临床疗效。方法：选择我院收治的有肺栓塞易栓因素的高危患者68例，随机分为研究组和对照组，各34例，对照组给予低分子肝素钙5000U，皮下注射，1次/12h；研究组同时加用注射用纤溶酶100U，溶于生理盐水250mL中静脉滴注，1次/d，两组疗程均为7d。观察两组患者治疗前后血浆组织型纤溶酶原激活物（tPA）、纤溶酶原激活物特异性抑制物（ PAI-1）活性及凝血酶原时间（ PT）、部分凝血活酶时间（APTT）、纤维蛋白原（Fib）含量、D-二聚体（ D-D）水平。结果：①治疗后两组Fib、D-D含量降低， tPA、PAI-1活性降低（ P＜0．05）。研究组Fib、D-D含量明显低于对照组，tPA、PAI-1活性也低于对照组（ P＜0．05）。②治疗期间，研究组无肺栓塞发生，对照组3例发生肺栓塞，发生率为8．8％，两组比较有统计学差异（ P＜0．01）。③两组治疗期间均无颅内出血、消化道出血以及其他部位出血等并发症。结论：对有肺栓塞易栓因素的患者预防性应用纤溶酶联合低分子肝素钙治疗，可以有效的改善患者纤溶-凝血系统，预防肺栓塞发生。
목적：관찰주사용섬용매연합저분자간소개치료폐전새역전인소환자적림상료효。방법：선택아원수치적유폐전새역전인소적고위환자68례，수궤분위연구조화대조조，각34례，대조조급여저분자간소개5000U，피하주사，1차/12h；연구조동시가용주사용섬용매100U，용우생리염수250mL중정맥적주，1차/d，량조료정균위7d。관찰량조환자치료전후혈장조직형섬용매원격활물（tPA）、섬용매원격활물특이성억제물（ PAI-1）활성급응혈매원시간（ PT）、부분응혈활매시간（APTT）、섬유단백원（Fib）함량、D-이취체（ D-D）수평。결과：①치료후량조Fib、D-D함량강저， tPA、PAI-1활성강저（ P＜0．05）。연구조Fib、D-D함량명현저우대조조，tPA、PAI-1활성야저우대조조（ P＜0．05）。②치료기간，연구조무폐전새발생，대조조3례발생폐전새，발생솔위8．8％，량조비교유통계학차이（ P＜0．01）。③량조치료기간균무로내출혈、소화도출혈이급기타부위출혈등병발증。결론：대유폐전새역전인소적환자예방성응용섬용매연합저분자간소개치료，가이유효적개선환자섬용-응혈계통，예방폐전새발생。
Objective:To observe the effect of plasmin combined with low molecular weight heparin cal-cium in the treatment of patients with risk factors of pulmonary embolism .Method:68 cases with pulmonary embolism risk factors were randomly divided into study group and control group , each with 34 cases, the control group was treated with low molecular weight heparin calcium 5000U, subcutaneous injection , once/12h; research group combined with injection of plasmin 100U, soluble in students physiological saline 250mL intravenous drip, once a day, two groups were treated for 7 days.Observed plasma tissue type plas-minogen activator (tPA), plasminogen activator inhibitor ( PAI-1) specific activity and prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib) content, D-dimer (D-D) level of two groups.Result:After treatment, Fib, D-D content were decreased , PAI-1 activity, tPA activity were reduced ( P<0.05) .Fib, D-D content in study group was significantly lower than that of the control group , the tPA, PAI-1 activity was lower than that of the control group ( P<0.05).No pulmonary embolism oc-curred in study group , 3 cases pulmonary embolism in the control group , the incidence rate was 8.8%( P<0.01) .There's no intracranial hemorrhage , hemorrhage of digestive tract and other parts of bleeding compli-cations during the treatment in the two groups .Conclusion: Plasmin combined with low molecular weight heparin calcium can effectively improve the patient's fibrinolysis coagulation system , prevent the pulmonary embolism.