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首页> 美国卫生研究院文献>Clinical and Applied Thrombosis/Hemostasis >Catheter-Directed Thrombolysis With a Continuous Infusion of Low-Dose Alteplase for Subacute Proximal Venous Thrombosis: Efficacy and Safety Compared to Urokinase
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Catheter-Directed Thrombolysis With a Continuous Infusion of Low-Dose Alteplase for Subacute Proximal Venous Thrombosis: Efficacy and Safety Compared to Urokinase

机译：持续低剂量阿替普酶输注的导管定向溶栓治疗亚急性近端静脉血栓形成：与尿激酶相比疗效和安全性

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The purpose of this study was to compare the efficacy and safety associated with catheter-directed thrombolysis (CDT) using either recombinant tissue plasminogen activator (rt-PA) or urokinase (UK) for subacute deep venous thrombosis (DVT). From January 2014 to December 2016, we conducted a retrospective analysis on a total of 49 patients who underwent consistent CDT with either rt-PA (rt-PA-CDT group) or UK (UK-CDT group) treatment. The thrombolytic rate of the rt-PA-CDT group was significantly higher than that of the UK-CDT group (87.5% vs 60%, respectively; χ2 = 4.751; P = .029). The rt-PA-CDT group exhibited an improved grade III thrombolytic rate (9 patients vs 3 patients; χ2 = 5.144; P = .023). The time for the rt-PA-CDT group to achieve a grade III thrombolytic rate was shorter than that of the UK-CDT group (5.01 ± 1.09 days vs 6.43 ± 1.69 days, respectively; t = −2.187; P = .044). No severe complications were seen in either group and mild complications rates were 16.7% and 20.0% (χ2 = .091; P = .763). The clinical efficacy rates at discharge were 91.7% and 76.0%, respectively (χ2 = 2.200; P = .138). In conclusion, CDT with a continuous infusion of low-dose rt-PA resulted in safe and effective thrombolysis in the great majority of patients with proximal DVT in the subacute phase. Furthermore, rt-PA was significantly better than UK in terms of the thrombolytic rate. In our study, rt-PA-CDT improved the thrombolytic rate of grade III thrombus and achieved a grade III thrombolytic rate in a shorter time than UK-CDT.
机译：这项研究的目的是比较使用重组组织纤溶酶原激活剂（rt-PA）或尿激酶（UK）进行亚急性深静脉血栓形成（DVT）的导管定向溶栓术（CDT）的疗效和安全性。从2014年1月至2016年12月，我们对总共49例接受rt-PA（rt-PA-CDT组）或UK（UK-CDT组）治疗的CDT一致的患者进行了回顾性分析。 rt-PA-CDT组的溶栓率显着高于UK-CDT组（分别为87.5％和60％；χ 2 = 4.751； P = .029）。 rt-PA-CDT组表现出更高的III级溶栓率（9例vs 3例；χ 2 = 5.144； P = .023）。 rt-PA-CDT组达到III级溶栓率的时间比UK-CDT组短（分别为5.01±1.09天和6.43±1.69天； t = -2.187； P = .044） 。两组均未见严重并发症，轻度并发症发生率分别为16.7％和20.0％（χ 2 = .091； P = .763）。出院时的临床有效率分别为91.7％和76.0％（χ 2 = 2.200； P = .138）。总之，在亚急性期，大多数持续性DVT近端患者中，CDT持续输注低剂量rt-PA可导致安全有效的溶栓治疗。此外，就溶栓率而言，rt-PA明显优于英国。在我们的研究中，rt-PA-CDT比UK-CDT在更短的时间内提高了III级血栓的溶栓率，并达到了III级血栓溶解率。

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