瑞替普酶与阿替普酶溶栓治疗急性大面积肺栓塞疗效对比分析

Efficacy of Reteplase and Ateplase in Treatment of Acute Massive Pulmonary Throm boembolism:A Comparative Study

目的评价急诊应用瑞替普酶与阿替普酶溶栓治疗急性大面积肺栓塞的疗效,寻找最佳治疗方案。方法回顾性分析华北石油总医院2005年1月至2009年12月经急诊收治的急性大面积肺栓塞的42例患者,其中瑞替普酶组18例,阿替普酶组24例,分别予以静脉溶栓治疗,观察溶栓有效率、出血不良反应及住院期间的病死率。结果经急诊溶栓治疗后瑞替普酶组溶栓有效率为88.9%,发生轻度出血3例,中度出血1例,住院期间死亡患者2例;阿替普酶组溶栓有效率为75%,轻度出血3例,中度出血2例,住院期间死亡患者3例。两组溶栓有效率、出血不良反应发生率及住院期间病死率均无统计学差异。结论瑞替普酶与阿替普酶均适用于急性大面积肺栓塞的溶栓治疗,由于瑞替普酶溶栓便捷易行,因而更适合于急诊溶栓治疗。

Objective To compare the efficacy of reteplase and ateplase in the treatment of acute massive pulmonary thromboembolism（PTE） in emergency.Methods From January 2005 to December 2009,42 patients with acute massive PTE were treated by intravenous thrombolysis with reteplase or ateplase.The thrombolysis efficacy,bleeding incidence and mortality were measured.Results In the reteplase group,the emergency thrombolysis effective rate was 88.9% among 18 patients.Mild bleeding occurred in 3 patients,moderate bleeding in 1 patient,and 2 cases died in hospital.In the ateplase group,the emergency thrombolysis effective rate was 75% among 24 patients.Mild bleeding occurred in 3 patients,moderate bleeding in 2 patients,and 3 cases died in hospital.The thrombolysis effective rate,bleeding incidence and mortality had no significant difference between the two groups.Conclusion Both the reteplase and ateplase thrombolysis therapy are safe and effective in the treatment of acute massive PTE,but reteplase thrombolysis therapy is more convenient in emergency.