Comparison of the efficacy of regional perfusion reteplase and alteplase in patients with pulmonary embolism / 中国基层医药

ABSTRACT

Objective To compare the therapeutic efficacy of reteplase(r-PA) and alteplase(t-PA) in the high risk patients with pulmonary embolism during a pulmonary artery catheter broken bolt in the interventional treatment,and to evaluate the clinical safety.Methods 54 high risk patients were selected as the research subjects,and they were randomly divided into treatment group(24 patients) and control group(30 patients).Patients in both two groups were given general treatment,low molecular heparin sodium anticoagulation therapy.Besides,the control group was given local perfusion thrombolysis enzyme treatment.While the treatment group was given local perfusion at enzyme thrombolysis treatment.Results Two-way Chi-square test results showed that before treatment,there were no significant differences in HR,RF,PaO2,PaCO2 and SaO2 between the two groups(all P>0.05).After 3-day treatment,in the treatment group,HR[(83.39±14.25)times/min],RF[(17.80±1.65)times/min],PaO2[(87.59±7.34)mmHg],PaCO2[(37.60±7.62)mmHg],SaO2[(97.29±6.72)%] in the treatment group group,which in the control group were (97.7±15.51)times/min,(20.49±1.68)times/min,(81.53±6.42)mmHg,(35.69±4.57)mmHg,(93.91±3.27)%,the differences between the two groups were statistically significant(t=8.01,7.33,6.32,all P<0.05).After three days therapy,the total effective rate was 86.67% in the treatment group,which was significantly higher than 75.00% in the control group (x2=1.21,P=0.55).After thrombolysis treatment,there was no significant difference between the treatment group and control group in hemorrhage rate(x2=2.24,P=0.53),which were 13.33% and 12.50%,respectively.Besides,the hemorrhage patients were all got effectively treated and their condition was significantly improved,and none of them occurred severe bleeding during the observation periods in the two groups.Conclusion Local perfusion reteplase therapy in high-risk patients with PE through the pulmonary artery catheter broken bolt in the interventional treatment is safe and is worthy of clinical promotion.