尿激酶和前列腺素E1联合溶解深静脉血栓的临床研究

Clinical Study on Thrombolysis of Deep Venous Thrombosis Using Urokinase Plus Prostaglandin E 1

目的：观察静脉内联用尿激酶（ＵＫ）和前列腺素Ｅ１（ＰＧＥ１）对下肢深静脉血栓（ＤＶＴ）患者的溶栓效果。方法：将８９例经静脉造影确诊为ＤＶＴ患者分为联合溶栓组［ＵＫ＋ＰＧＥ１ｎ＝５１，第１组（病程＜２周）：先静脉注射ＵＫ１０万ＩＵ，接着静脉滴注ＵＫ（３万ＩＵ／ｈ）及ＰＧＥ１（１００μｇ／ｄ）持续２～３天，之后持续静脉滴注肝素钠５～７天，再服用华法林（使凝血酶原时间为基础对照的１．５～２．０倍）３～６个月；第２组（病程＞２周）：静脉注射ＵＫ１０万ＩＵ后，静脉滴注ＵＫ２０万ＩＵ及ＰＧＥ１１００μｇ，每日１次，连用７～１０天，再服华法林３～６个月］和常规治疗组（肝素，ｎ＝３８，剂量同上）。以血管造影为标准判断溶栓效果。结果：联合溶栓组的疗效明显优于常规治疗组（Ｐ＜０．０１）；其疗效与病程长短关系密切，病程小于２个月者疗效显著（显效率７５％，总有效率９６．５％）；无严重并发症发生。结论：静脉内联用ＵＫ和ＰＧＥ１治疗ＤＶＴ是一种安全、有效的治疗方法。

Objective: To report the thrombolytic effects of intravenous urokinase (UK) plus prostaglandin E 1 (PGE 1) on deep venous thrombosis (DVT). Methods: Eighty nine patients with DVT diagnosed by venography were divided into thrombolytic group [UK+PGE 1, n =51, group 1 (course of disease <2 weeks): UK (1×10 5 IU initial dose and 3×10 4 IU/h)+PGE 1(100 μg/d) iv drip for 2-3 days, followed by heparin (500-1000 IU/h) iv drip for 5-7 days and then warfarin with dosage to mainain the prothrombin time 1 5-2 0 fold of basic value for 3-6 months; group 2 (course of disease >2 weeks): UK initial dose as group 1 and 2×10 5 IU/d+PGE 1 100μ g/d iv drip for 7-10 days) and then warfarin was given for 3-6 months] and routine group ( n =38 heparin, with dosage as in group 1) , and the thrombolytic effects were ascertained by venography. Results: Effects of the thrombolytic group were significantly better than that of the routine group ( p <0 01); the thrombolytic effects were related to the course of the disease, and the effect of the course <2 months was significant (significant effective rate was 75%, total effective rate was 96 5%); no severe complication was found. Conclusion: Combined use of UK and PGE 1 is a kind of safe and effective therapy for deep vein thrombosis.