Clinical Observation Of Recombinant Human Pro-urokinase Thrombolytic Therapy For Acute Pulmonary Embolism

Objective:To compare the clinical efficacy and complications of thrombolytic therapy with recombinant human prourokinase(pro-UK)and thrombolytic therapy with recombinant human tissue plasminogen anctivator(rt-PA)in acute pulmonary embolism(APE),to provide clinical reference for the treatment of acute pulmonary embolism.Method:The clinical data of 46 patients with acute pulmonary embolism admitted to the affiliated hospital of Yanbian university from January 2018 to January 2021 were analyzed retrospectively.The patients were divided into 2 groups,pro-UK thrombolytic therapy group was 25 cases in observation group and RT-PA thrombolytic therapy group was 21 cases in control group.All patients were diagnosed by d-dimer,computed tomographic pulmonary angiography(CTPA)or pulmonary angiography,and the lesions involved segmental or subsegmental pulmonary arteries.The clinical symptoms and changes of CTPA and D-dimer of pulmonary artery were recorded after treatment.Statistical analysis showed that the difference was significant(P < 0.05).Results:1.There was no difference between the Observation Group and the control group in sex,smoking,body mass index,incidence of diabetes and hyperlipemia(P > 0.05),respectively,the age was 69.88±11.72,57.19±15.32(X~2=3.181,P=0.003);the incidence of hypertension was 60%,23.8%(X~2=6.083,P=0.014);the incidence of lower extremity venous thrombosis was 88%,28.6%(X~2=16.923,P=0.000),the statistical difference was significant(P < 0.05).2.There was a significant difference in therapeutic effect between the observation group and the control group(P < 0.05).The therapeutic effect of the observation group was obviously higher than the control group.3.There was no significant difference in adverse reaction between the observation group and the control group(P > 0.05),which showed that there was no significant difference in adverse reaction between the experimental group and the control group.4.The levels of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT)and pro-fibrinolysin(Fg)before treatment were compared between the observation group and the control group,the difference was not statistically significant(P > 0.05).After treatment,PT was 12.61±2.7,15.67±4.05(X~2=-3.054,P=0.004).The difference between the two groups was significant(P <0.05)Conclusions:1.Pro-UK thrombolytic therapy for acute pulmonary embolism is feasible,safe and effective.2.The effect of Pro-UK thrombolytic therapy in acute pulmonary embolism is better than that of rt-PA thrombolytic therapy.