溶栓联合前列腺素E1治疗急性肺血栓栓塞症的效果

The effect of thrombolysis combined with prostaglandin E1 in the treatment of patients with acute pulmonarythromboembolism

目的探讨溶栓联合前列腺素E1（PGEl）治疗急性肺血栓栓塞症（APTE）的效果。方法选取88例符合溶栓条件的APTE患者，按照数字表法随机分为单纯溶栓组49例和联合PGEl组39例。单纯溶栓组给予常规溶栓治疗，联合PGEl组在常规溶栓治疗的基础上加用PGEl治疗。监测两组PaO2、PaCO2、肺动脉收缩压（PAsP）、肌钙蛋白I（cTNI）、B型钠尿肽（BNP）等指标水平，并进行临床疗效评价。结果联用PGEl组治疗后PAsP、cTNI、BNP水平均优于单纯溶栓组（t=2．173、2．349、2．495，均P〈0．05）；联用PGEl组临床有效率为82．1％，显著高于单纯溶栓组的59．2％（X^2=5．339，P〈0．05）。联用PGEl组严重事件发生率为7．7％，显著低于单纯溶栓组恶化24：5％（X2=4．333，p〈0．05）。结论溶栓联合应用PGEl治疗APTE，可以更好地降低肺动脉压力，保护心肌，更快地纠正右心功能不全，改善患者临床症状和短期预后。

Objective To evaluate the clinical effect of thrombotysis combined with prostaglandin E1 （PGE1） in the treatment of patients with acute pulmonary thromboembolism （APTE）. Methods According to the digital table,88 patients with APTE corresponding to thrombolytic therapy were randomly divided into the simply thrombolytic group（49 cases） and the joint PGE1 group（39 cases）. The simply thrombolytic group were given con- ventional thrombolysis, and the joint PGE1 group were given thrombolysis combined PGE1 therapy. The levels of PaO：, PaCO2, pulmonary artery systolic pressure （ PAsP）, cardiac troponin I （ eTNI）, B-type natriuretic peptide （BNP） were monitored, and the clinical efficacy was evaluated. Results After the treatment, the levels of PAsP, cTNI, BNP of the joint PGE1 group were better than those of the simply thrombolytic group （ t = 2. 173,2. 349,2. 495, all P 〈0. 05 ）. The clinical effective rate of the joint PGE1 group was 82.1% ,which was significantly higher than that of the simply thrombolyticgroup （ 59.2 % ） （ X^2 = 5. 339, P 〈 0.05 ）. The critical event occurrenceofthejoint PGE 1 groupwas 7.7%, which was significant lower than that of the simply thrombolytic group（ 24.5% ）（ X^2=4.333, P 〈 0.05 ）. Conclusion Thrombolysis combined PGE1 therapy may be more effective in reducing pulmonary artery pressure,pro- tecting myocardia,improving the right heart function than only thrombolysis, and thus improve clinical symptoms and short-term prognosis in the APTE patients.