阿替普酶联合华法林治疗慢阻肺合并肺栓塞的有效性分析
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摘要
目的分析阿替普酶联合华法林治疗慢阻肺(COPD)合并肺栓塞的有效性。方法回顾分析2017年10月～2018年10月在我院诊治的90例慢阻肺合并肺栓塞患者临床资料,将其随机分为对照组和观察组,各45例,对照组采用肝素联合华法林治疗,观察组采用阿替普酶联合华法林治疗,对比两组临床治疗有效率、凝血功能指标(PT、APTT、TT、Fbg)、动脉血PO_2、PCO_2、血清心肌肌钙蛋白Ⅰ(cTnⅠ)以及不良反应。结果观察组治疗总有效率(95.55%)与对照组(91.11%)对比,差异有统计学意义(P<0.05);治疗后两组患者PT、APTT、TT较治疗前降低,Fbg升高,组间比较差异有统计学意义(P<0.05);治疗后两组动脉血PO_2升高,动脉血PCO_2、cTnⅠ降低,与治疗前对比,组间对比差异有统计学意义(P<0.05);两组均未发生明显不良反应。结论阿替普酶联合华法林治疗COPD合并肺栓塞具有良好的有效性,且用药安全,同时在改善心肌损伤方面具有良好的效果。
Objective To analyze the efficacy of alteplase combined with warfarin in the treatment of chronic obstructive pulmonary disease with pulmonary embolism. Methods The clinical data of 90 patients with chronic obstructive pulmonary disease complicated with pulmonary embolism diagnosed and treated in our hospital from October 2017 to October 2018 were retrospectively analyzed. They were randomly divided into two groups:control group(n=45) and group(n=45). The control group was treated with heparin combined with warfarin. The patients in the observation group were treated with ateptidase combined with warfarin. The effective rate, coagulation function index(PT,APTT,TT,Fbg),Arterial blood PO_2,PCO_2, serum cardiac troponin I(cTnI) and adverse reactions. Results The total effective rate of treatment in the observation group was 95.55% compared with 91.11% in the control group,the difference was statistically significant(P <0.05). After treatment, the PT, APTT and TT of the two groups were lower than before treatment and the Fbg was increased,the difference between the groups, the difference was statistically significant( P<0.05); after treatment, the arterial blood PO_2 increased, arterial blood PCO_2, cTnI decreased, compared with the pre-treatment, the difference between the groups was statistically significant(P <0.05); no significant adverse reactions occurred in either group. Conclusion Alteplase combined with warfarin is effective in the treatment of COPD with pulmonary embolism and is safe to use. At the same time, it has a good effect in improving myocardial damage.
Objective To analyze the efficacy of alteplase combined with warfarin in the treatment of chronic obstructive pulmonary disease with pulmonary embolism. Methods The clinical data of 90 patients with chronic obstructive pulmonary disease complicated with pulmonary embolism diagnosed and treated in our hospital from October 2017 to October 2018 were retrospectively analyzed. They were randomly divided into two groups:control group(n=45) and group(n=45). The control group was treated with heparin combined with warfarin. The patients in the observation group were treated with ateptidase combined with warfarin. The effective rate, coagulation function index(PT,APTT,TT,Fbg),Arterial blood PO_2,PCO_2, serum cardiac troponin I(cTnI) and adverse reactions. Results The total effective rate of treatment in the observation group was 95.55% compared with 91.11% in the control group,the difference was statistically significant(P <0.05). After treatment, the PT, APTT and TT of the two groups were lower than before treatment and the Fbg was increased,the difference between the groups, the difference was statistically significant( P<0.05); after treatment, the arterial blood PO_2 increased, arterial blood PCO_2, cTnI decreased, compared with the pre-treatment, the difference between the groups was statistically significant(P <0.05); no significant adverse reactions occurred in either group. Conclusion Alteplase combined with warfarin is effective in the treatment of COPD with pulmonary embolism and is safe to use. At the same time, it has a good effect in improving myocardial damage.
引文
[1]陈振华,丘新才,林淑芳,等.阿替普酶联合华法林治疗慢性阻塞性肺疾病合并肺栓塞的效果观察[J].山东医药,2016,56(28):93-95.
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[5]李阳.老年慢阻肺合并肺结核临床治疗效果观察研究[J].中国卫生标准管理,2015,6(2):163-164.