瑞替普酶和尿激酶静脉溶栓治疗肺栓塞疗效和安全性的Meta分析

A Meta-analysis on reteplase and urokinase thrombolytic therapy in treatment of patients with pulmonary embolism

目的比较瑞替普酶与尿激酶静脉溶栓治疗肺栓塞的疗效与安全性。方法计算机检索Pubmed、Medline、CNKI、万方医学网等数据库,收集纳入瑞替普酶与尿激酶静脉溶栓治疗肺栓塞的随机对照试验,用Revman 5.3软件进行Meta分析。结果本文纳入7个研究。在疗效方面,瑞替普酶与尿激酶静脉溶栓治疗肺栓塞的有效率比较有统计学差异(P=0.002),即瑞替普酶静脉溶栓治疗肺栓塞的有效率高于尿激酶,且较溶栓前比较能明显地降低肺动脉压、改善氧分压;在安全性方面,瑞替普酶与尿激酶静脉溶栓治疗肺栓塞的出血率比较有统计学差异(P=0.02),即瑞替普酶出血发生率显著低于尿激酶。结论瑞替普酶静脉溶栓治疗肺栓塞疗效好,且出血发生率低。

Objective This study is conducted to evaluate the efficacy and safety of reteplase and urokinase thrombolytic therapy in treatment of patients with pulmonary embolism. Methods Such data based as Pubmed, Medline, CNKI, wangfang data and so on. Collected the randomized controlled trials about the treatment with reteplase and urokinase thrombolytic therapy in treatment of patients with pulmonary embolism. Revman 5.3 software was used for Meta-analysis. Results 7 studies were involved in. There were significant difference in the effective rate between the two groups(P=0.002). The effective rate was higher in the group of reteplase than urokinase; thrombolysis with reteplase was more effective in reducing pulmonary artery pressure and increasing oxygen partial pressure. There were significant difference in the bleeding rate between the two groups(P=0.02). The group of reteplase in the bleeding rate was lower than the group of urokinase. Conclusion Compared with urokinase, reteplase was more effective and less risky of bleeding.