不同剂量尿激酶经导管溶栓治疗下肢深静脉血栓形成的疗效

Curative effect of different dosage of urokinase for catheter-directed thrombolysis of deep venous thrombosis

目的:探讨不同剂量尿激酶在经导管溶栓治疗急性下肢深静脉血栓形成(DVT)中的有效性及安全性。方法:使用经导管溶栓治疗DVT,并按尿激酶用量、给药频率将患者分组,比较溶栓效果及随访结果差异。结果:100例患者治疗前后凝血指标结果显示尿激酶溶栓对纤维蛋白原(Fg)、血浆凝血酶原时间(PT)、D-二聚体的影响较大(P<0.05)。尿激酶剂量及频次分别为12.5万U/d、25万U/d、50万U/d,血栓溶解率分别是(44.65±6.29)%、(54.10±6.74)%及(55.01±7.85)%,12.5万U/d用量血栓溶解率较低,差异均有统计学意义(P<0.05)。尿激酶相同用量患者,2次/d的血栓溶解率高于1次/d(P<0.05)。出院后随访,患者一般情况渐渐明显改善,且随访期间各指标总体评分渐改善(P<0.05)。出院后1年肢体沉重、肿胀感基本消失。结论:尿激酶每日用量在25万U能达到较高的血栓溶解率和低的出血风险,且增加每日尿激酶给药频率,可以提高血栓溶解率。

Objective： To study the efficacy and safety of urokinase in the catheter-directed thrombolysis（CDT） treatment of acute deep venous thrombosis（DVT）of lower extremity. Methods：Patients enrolled were treated with CDT, and divided into different groups by different urokinase dose and frequency. Results： the coagulation indicators of 100 patients before and after treatment showed that Urokinase thrombolysis more affect Fg, PT, D-D dimer. With the increase of the frequency and dose urokinase, 125 kU/d, 250 kU/d, 500 kU/d, thrombolysis rate increases（44.65±6.29）%,（54.10±6.74）%,（55.01±7.85）% respectively, and the differences were statistically significant（P〈0.05）. As the follow-up time was prolonged, the general condition of the patients gradually improved, and the overall scores of each indicator gradually improved during the follow-up period.Conclusion： Dosage of urokinase daily in 250 kU can achieve a high rate of thrombolysis and low bleeding risk, and increase the daily urokinase dosing frequency, can raise rate of thrombolysis.