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目的观察小剂量尿激酶治疗慢性阻塞性肺疾病急性加重期的疗效及不良反应。方法 80例慢性阻塞性肺疾病急性加重期患者随机分为治疗组和对照组各40例。2组均常规治疗,包括鼻导管吸氧1～2L·min~(-1)、抗感染、解痉平喘、祛痰;治疗组在此基础上加用尿激酶100kU加入氯化钠注射液100mL中静脉滴注,30min滴完,每日1次,疗程为10d。观察2组患者治疗前后血气分析、临床疗效、血液流变学的指标变化及不良反应。结果对照组各项指标无明显改善(P>0.05),治疗组经尿激酶治疗后全血黏度、血浆黏度、全血还原黏度和纤维蛋白原比治疗前显著降低(P<0.01),2组治疗后各指标组间比较有非常显著差异(P<0.01)。2组治疗前血气分析指标无显著差异(P>0.05),治疗后p_aO_2增加,p_aCO_2降低,与治疗前比较及治疗后组间比较均有非常显著差异(P<0.01)。对照组治疗总有效率为65%,治疗组总有效率为85%,2组疗效有显著差异(P<0.05)。2组治疗期间均未出现明显不良反应。结论小剂量尿激酶治疗慢性阻塞性肺疾病急性加重期疗效佳,无明显不良反应。
Objective To observe the efficacy and adverse reactions of low-dose urokinase in the treatment of acute exacerbation of chronic obstructive pulmonary disease. Methods Eighty patients with acute exacerbation of chronic obstructive pulmonary disease were randomly divided into treatment group (40 cases) and control group (40 cases). Both groups were treated routinely, including 1 ~ 2L · min ~ (-1) oxygen in nasal cannula, anti-infective, antispasmodic and antiasthmatic, and expectorant treatment.Under the treatment group, 100kU of urokinase was added into 100mL sodium chloride injection Intravenous drip, 30min drip finished, day 1, treatment for 10d. Blood gas analysis, clinical curative effect, hemorheology index changes and adverse reactions before and after treatment in two groups were observed. Results The indexes of the control group showed no significant improvement (P> 0.05). The whole blood viscosity, plasma viscosity, whole blood reduced viscosity and fibrinogen were significantly decreased in the treatment group after treatment with urokinase (P <0.01) After treatment, there was a significant difference between each index group (P <0.01). There was no significant difference between the two groups in blood gas analysis before treatment (P> 0.05). After treatment, p_aO_2 increased and p_aCO_2 decreased. Compared with before treatment and after treatment, there was significant difference (P <0.01). The total effective rate of the control group was 65%, the total effective rate of the treatment group was 85%, there was significant difference between the two groups (P <0.05). No significant adverse reactions occurred in the two groups during the treatment. Conclusion Low-dose urokinase is effective in acute exacerbation of chronic obstructive pulmonary disease, with no obvious adverse reactions.