| Efficacy of reteplase combined with warfarin in the treatment of chronic obstructive pulmonary disease complicated with acute middle-risk pulmonary embolism |
| Received:May 25, 2020 Revised:July 21, 2020 Click here to download the full text |
| Citation of this paper:DU Jing,ZHU Shu-yang.Efficacy of reteplase combined with warfarin in the treatment of chronic obstructive pulmonary disease complicated with acute middle-risk pulmonary embolism[J].Chinese Journal of Clinical Medicine,2020,27(5):827-830 |
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| Abstract:Objective: To investigate the efficacy of reteplase (rPA) combined with warfarin in the treatment of chronic obstructive pulmonary disease (COPD) complicated with acute middle-risk pulmonary embolism. Methods: Totally, 76 COPD patients complicated with acute middle-risk pulmonary embolism diagnosed and treated in recent years were randomly selected and divided into the study group and the control group with the same number of cases in each group. The study group was treated with rPA combined with warfarin, and the control group was treated with low molecular weight heparin sodium sequential warfarin. The overall treatment efficacy, blood gas, D-dimer, myocardial injury marker levels, right/left ventricular maximum short axis diameter ratio (RVd/LVd), and adverse reactions were analyzed. Results: The effective rates of treatment in the study group and the control group were 94.7% and 78.9%, respectively, the difference was statistically significant (P<0.05). In the study group, PaO2 and SaO2 increased, PaCO2 decreased, and D-dimer decreased. The differences were statistically significant compared with the control group (P<0.05); after treatment, the levels of myocardial injury markers and RVd/LVd were reduced, and the differences between the groups were statistically significant (P<0.05). Observation was started after thrombolytic anticoagulation treatment in each group, untill 60 days after the end of the treatment period, there were no deaths in both groups. There were 1 abnormal bleeding and 1 recurrence of pulmonary embolism in the study group; 6 abnormal bleeding and 3 recurrences of pulmonary embolism in the control group. Patients in the study group had less abnormal bleeding, and the recurrence rate of pulmonary embolism was also significantly lower than that in the control group (P<0.05). Conclusions: The rPA combined with warfarin in the treatment of COPD complicated with acute middle -risk pulmonary embolism can effectively improve symptoms, suppress myocardial injury, reduce adverse reactions, and is more safe and effective. |
| keywords:chronic obstructive pulmonary disease acute pulmonary embolism intermediate risk reteplase |
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