蝮蛇抗栓酶在结核性胸腔积液治疗中的抗纤维化作用

The Role of Ahylysantinfarctase in Reducing Fibrosis of Tuberculous Pleural Effusion

目的 :探讨蝮蛇抗栓酶在治疗结核性纤维化性胸腔积液中的作用。方法 :发生胸膜粘连肥厚明显趋势的结核性渗出性胸膜炎 6 1例 ,随机分为注药组 (2 8例 )和非注约组 (33例 ) ,注药组每次抽液后注入蝮蛇抗栓酶 0 .5U ,其他治疗措施两组相同。结果 :注药组抽液总量 (110 8± 32 8)ml,非注药组 (6 35± 2 81)ml(P <0 .0 1) ;注药组总有效率 89.3% ,非注药组 6 0 .6 % (P <0 .0 5 ) ;注药组胸膜肥厚发生率 5 0 .6 % ,非注药组 81.8% (P <0 .0 1) ,平均注药次数(3.6± 1.5 ) (2～ 8)次。结论 :在规则抗痨治疗下 ,胸腔内注入蝮蛇抗栓酶能显著增加胸液引流量 ,提高疗效 ,降低胸膜肥厚的发生。

Objective: To investigate the effects of intrapleural ahjylysantinfarctase for patients with tuberculous pleural effusion. Methods: The sixty-one patients were chosen so that the patients with tuberculous pleural effusion had high incidence of occurring pleural adhesion and thickening. They were randomized into two groups, intrapleural ahylysantinfarctase group (groupⅠ) and conventional group (group C). The patients in group Ⅰ were injected with apylysantinfarctase 0.5u.intrapleurally after each thoracocentesis; the other therapies were similar to that of group C.Results: The mean volume of fluid drained in group Ⅰ was (1 108±328) ml, while it was (635±281) ml in group C( P <0.01),the total effective rate was 89.3% in group Ⅰ and 60.6% in group C( P <0.05), the incidence of pleural thickening in group Ⅰ was 50.6%, while it was 81.8% in group C( P <0.01).The mean number of injection was (3.6±1.5)(ranged 2～8).Conclusion: For patient with tuberculous pleural effusion, regular antituberculosis treatment plus ahylysantinfarctase injection into the pleural cavity can evidently increase the drainage, improve the therapeutic effectiveness, and decrease pleural thickening. There is a statistical difference between two groups.