重组人组织型纤溶酶原激酶衍生物治疗下肢深静脉血栓的临床疗效

Clinical efficacy of human tissue plasminogen kinase derivatives in the treatment of lower extremity deep vein thrombosis

目的探讨重组人组织型纤溶酶原激酶(rt-PA)衍生物溶栓治疗下肢深静脉血栓(DVT)患者的疗效及安全性。方法收集2021年11月至2022年5月于郑州大学第一附属医院行导管接触性溶栓(CDT)的41例下肢DVT患者的临床资料,按照治疗方式的不同将其分为观察组(n=16,采用rt-PA衍生物联合阿加曲班泵入)和对照组[n=25,采用尿激酶(UK)联合阿加曲班泵入]。比较两组患者大腿及小腿消肿率、凝血酶原时间(PT)、纤维蛋白原(FIB)、血小板计数(PLT)、置管溶栓时间、住院时间、住院费用及并发症发生率。结果溶栓后,两组患者PT均长于本组溶栓前,且观察组患者长于对照组患者,差异均有统计学意义(P﹤0.05);观察组患者FIB低于对照组患者,差异有统计学意义(P﹤0.05)。观察组患者住院时间、置管溶栓时间均短于对照组患者,差异均有统计学意义(P﹤0.05)。两组患者住院费用、大腿及小腿消肿率比较,差异均无统计学意义(P﹥0.05)。两组患者并发症发生率比较,差异无统计学意义(P﹥0.05)。观察组患者Ⅲ级血栓清除率高于对照组患者,差异有统计学意义(P﹤0.05)。结论rt-PA衍生物可作为下肢DVT患者溶栓治疗的首选药物,安全、有效,值得临床进一步推广应用。

Objective To investigate the efficacy and safety of recombinant human tissue plasminogen kinase(rtPA)derivative thrombolysis in the treatment of patients with lower extremity deep vein thrombosis(DVT).Method The clinical data of 41 lower extremity DVT patients who underwent catheter-directed thrombolysis(CDT)at the First Affiliated Hospital of Zhengzhou University from November 2021 to May 2022 were collected.They were divided into observation group(n=16,given rt-PA derivative combined with argatroban pump)and control group[n=25,given urokinase(UK)combined with argatroban pump]according to different treatment methods.The thigh and calf swelling rates,prothrombin time(PT),fibrinogen(FIB),platelet count(PLT),catheter thrombolysis time,hospitalization time,hospitalization costs,and complication rates were compared between the two groups.Result After thrombolysis,the PT of the two groups were longer than those before thrombolysis,the PT of observation group was longer than that of the control group,the differences were statistically significant(P<0.05).The FIB of the observation group was lower than that of the control group patients,the difference was statistically significant(P<0.05).The hospitalization time and catheter thrombolysis time in the observation group were shorter than those of the control group,the differences were statistically significant(P<0.05).There were no statistically significant differences in the hospitalization expenses,thigh and calf swelling rates between the two groups(P>0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).The levelⅢthrombus clearance rate in the observation group was higher than that of the patients in the control group,the difference was statistically significant(P<0.05).Conclusion The rt-PA derivatives could be used as the first-line drug for thrombolytic treatment in patients with lower extremity DVT.They are safe and effective,worthy of further clinical promotion and application.