Application Of Different Doses Of Recombinant Human Urokinase In Thrombolytic Therapy Of Acute Lower Extremity Deep Venous Thrombosis

Objective To investigate the efficacy and safety of different doses of recombinant human urokinase in the treatment of acute deep venous thrombosis of lower limbs(LEDVT),and to provide clinical reference for thrombolytic therapy of acute deep venous thrombosis of lower limbs.Methods A total of 160 patients with acute lower limb deep vein thrombosis who met the inclusion criteria in The Affiliated Hospital of Inner Mongolia Medical University from June 2019 to October 2021 were selected and divided into four groups A,B,C and D according to the hospitalization sequence,with 40 patients in each group.All patients received catheter-directed thrombolysis(CDT).Group A,B and C were given10 mg,20 mg and 30 mg recombinant human urokinase,respectively.Group D was given 500,000 IU urokinase thrombolytic therapy.The circumference difference of affected limb was compared between 2 days after thrombolytic therapy and the end day of thrombolytic therapy,as well as the mean thrombosis clearance rate and the degree of thrombolysis,the incidence of adverse reactions and the abnormal rate of coagulation indicators in iliac vein and femoral vein of each group.Statistical analysis was conducted,and P < 0.05 was considered as significant difference.Results1.The average actual days of thrombolytic therapy were 6.15 days in group A,3.33 days in group B,2.38 days in group C,and 6.39 days in group D.After 2 days of thrombolytic therapy,the difference in thigh circumference of affected limbs in the four groups was[M(QR):2.00(0.4)cm VS 2.80(1.5)cm VS 2.80(1.1)cm VS 2.10(0.6)cm,respectively],in calf circumference difference [M(QR):1.55(0.9)cm VS 2.00(1.05)cm VS 1.90(0.5)cm VS 1.50(0.85)cm,respectively].The difference of affected limb circumference in groups A and D was lower than that in groups B and C,and the difference was statistically significant(P < 0.05).At the end of thrombolytic therapy,the difference in thigh circumference of affected limb and thigh in the four groups(?x±S:5.08 ± 0.61 cm VS 2.93 ± 0.59 cm VS 2.77 ± 0.61 cm VS 3.62 ± 0.59cm),in calf circumference difference[M(QR):2.50(0.3)cm VS 2.10(0.5)cm VS 1.90(0.5)cm VS2.20(0.3)cm,respectively],The difference in diameter of large leg and lower leg in group D was lower than that in group A,and higher than that in groups B and C,with statistical significance(P < 0.05).2.The degree of thrombus clearance in group D was lower than that in group A,B and C,and the degree of mean thrombus clearance in group D was higher than that in group A,B and C,and the difference was statistically significant(P < 0.0083).The proportion of patients with average thrombus clearance rate higher than 50% and lower than 50% in the four groups was pally compared.The number of patients with thrombus clearance rate higher than 50% in group D was less than that in group A,B and C,and the number of patients with thrombus clearance rate lower than 50% was more than that in group A,B and C,with statistical significance(P < 0.0083).Conclusions1.There was no significant difference in the thrombectomy efficacy(detumation degree,thrombectomy clearance rate)of 10 mg,20 mg and 30 mg recombinant human urokinase groups,which were superior to urokinase.2.In the early stage of treatment,the detumescence degree and vascular patency rate of20 mg and 30 mg recombinant human urokinase were better,but the abnormal rate of coagulation index was higher.The risk of adverse reactions and abnormal coagulation index in acute deep vein thrombolysis treated with 10 mg recombinant human urokinase were lower.It has certain clinical reference value for thrombolytic therapy of acute deep vein thrombosis.