To explore the clinical efficacy and safety of lumbrokinase in the treatment of acute and moderate risk pulmonary thromboembolism. Methods: The clinical data of 60 patients with acute and moderate risk pulmonary thromboembolism, who were collected from January 2010 to October 2015 in Hunan Provincial People's Hospital, were retrospectively analyzed. According to the different treatments, 60 patients were randomly divided into a lumbrokinase group (lumbrokinase in combination with low molecular heparin and sequential warfarin, n=30) and a control group (low molecular heparin and sequential warfarin, n=30). The clinical efficacy and safety were compared between the two groups. Results: Compared with the control group, maximum short axis, ratio of right and left ventricles, systolic pulmonary artery pressure, and the main pulmonary artery diameter in the lumbrokinase group were significant changed after the treatment for 10, 20 and 30 d. NT-proBNP level in the lumbrokinase group after the treatment for 10, 20 and 30 d was significantly reduced than that in the the control group (P<0.05). However, the value of PO2 significantly increased after 10, 20 and 30 d, and there was no significant difference between 20 d and 30 d (P>0.05). D-dimer in the two groups was obviously increased after treatment for 10 d, but it was significantly reduced after treatment for 20 d or 30 d (P<0.05). The clinical efficacy of the lumbrokinase group was better than that in the control group, with significant difference (P<0.05). Conclusion: Combination of lumbrokinase with low molecular heparin and sequential warfarin is a safe and efficient strategy in treating the patients with acute and moderate risk pulmonary thromboembolism. It is worthy of clinical popularization and application.
目的：探讨蚓激酶对急性中危肺血栓栓塞的治疗效果及安全性。方法：回顾性分析2010年1月至2015年10月在湖南省人民医院住院治疗的60例急性中危肺血栓栓塞患者的临床资料，依据治疗方式不同分为蚓激酶组(蚓激酶联合低分子肝素钠序贯华法林组)和对照组(低分子肝素钠序贯华法林组)，每组30例。比较两组在治疗前、治疗后10，20及30 d的临床疗效及安全性。结果：CT肺动脉造影(CT pulmonary angiography，CTPA)和超声心动图结果表明蚓激酶组右心室最大短轴直径、左心室最大短轴直径、右心室最大短轴直径与左心室最大短轴直径比值、肺动脉收缩压和主肺动脉直径在治疗后10，20及30 d与对照组比较差异均有统计学意义(P<0.05)，且两组在治疗后10，20及30 d比较差异均有统计学意义(P<0.05)。与对照组比较，蚓激酶组N末端B型脑钠肽原(NT-proBNP)在治疗后10，20和30 d明显降低(P<0.05)。对照组和蚓激酶组氧分压(PO2)在治疗后10，20和30 d明显升高，但治疗后20和30 d两组比较差异无统计学意义(P>0.05)。D-二聚体在对照组和蚓激酶组治疗后10 d明显增高，而在治疗后20，30 d明显降低，且两组及组内比较差异均有统计学意义(P<0.05)。蚓激酶组临床疗效优于对照组(P<0.05)。结论：蚓激酶联合低分子肝素钠序贯华法林治疗急性中危肺血栓栓塞患者临床疗效显著且安全，值得临床推广。.