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目的分析急性次大面积肺血栓栓塞症(PTE)溶栓治疗前后心功能的变化,了解溶栓治疗对急性右心功能不全的影响,从而探讨此方法的临床疗效及安全性。方法回顾性分析2008年2月至2009年5月住院的8例急性次大面积PTE患者尿激酶溶栓治疗前后心率、心脏超声、血心肌肌钙蛋白I(cTnI)及B型利钠肽(BNP)的变化。结果8例患者溶栓治疗后均有心率下降,右房、右室显著缩小,肺动脉压力降低,cTnI、BNP降低,右心功能不全改善。无致死性出血及严重的颅内出血。结论急性次大面积PTE积极予以溶栓治疗可以早期改善右心功能不全,改善患者预后。
Objective To analyze the changes of cardiac function before and after thrombolytic therapy in acute sub-large pulmonary thromboembolism (PTE), and to understand the influence of thrombolytic therapy on acute right-ventricular dysfunction and to explore the clinical efficacy and safety of this method. Methods The changes of heart rate, cardiac ultrasound, cardiac troponin I (cTnI) and B-type natriuretic peptide (BNP) before and after thrombolytic therapy of urokinase in 8 acute subgroup of PTE patients hospitalized from February 2008 to May 2009 were retrospectively analyzed. BNP) changes. Results After the thrombolytic therapy in 8 patients, the heart rate decreased, the right atrium and the right ventricle decreased significantly, the pulmonary artery pressure decreased, the cTnI and BNP decreased, and the right ventricular dysfunction improved. No fatal bleeding and severe intracranial hemorrhage. Conclusion The acute sub-large area PTE positive thrombolytic therapy can improve early right ventricular dysfunction and improve prognosis.