| PrefacePulmonary embolism (PE) is a syndrome caused by emboluses which obstructing the pulmonary arterial system. Pulmonary thromboembolism(PTE) is the most common kind of pulmonary embolism obstructed by thrombus . The situation of PTE is high incidence rate and high mortality , omitting diagnose and misdiagnose condition are commonly seen. So PTE becomes an important disease in the whole world.An effective and standardization therapy can decrease the mortality, improving the outcome of patients with PTE. Experts all over the world are always exploring the ideal methods. anticoagulation is the basic therapy to non-massive PTE ,UH and LMWH are most commonly used. But it didn' t come to an agreement about the efficiency , the safety and cost-effective ratio of UH andLMWH.We divided the patients with non-massive acute PTE into two groups, one group got UH therapy and the another got LMWH therapy, both groups were observed oxygenation index, D-dimer, fibrinogen(FG), lung ventilation/perfusion scan(V/Q), computed tomography pulmonary angiography (CTPA). Data of these above items were statistics analyzed to evaluate the efficiency , safety and cost-effective ratio about UH and LMWH.Patients and Methods1. All patients are from Sir Run Run Shaw Hospital-The Affiliated Hospital of Zhejiang University , ranging from 2000. 9 to 2003. 4. There are 16 patients in UH group (10 male and 6 female), 54.24+15.86 years old in average. 25 patients in UH group (16 male and 9 female), 51. 43+12. 57 years old in average. The diagnosis standard is according to "diagnosis and treatment of PTE draft" .2. UH group patients got UH of 80IU/Kg iv then 18IU/(kg. h) iv pump, monitoring APTT in the course of therapy. Warfarin should be added when APTT reach 1.5-2.5 times to controlled group. UH can be stopped After PT become 2. 0-3. 0 for two days. The total anticoagulation course is three months or even longer.LMWH group patients got LMWH of 0.1ml/10kg subcutaneous injection, Warfarin should be added in day two. LMWH can be stopped After PT become 2. 0-3. 0 for two days. The total anticoagulation course is three months or even longer.oxygenation index, D-dimer, FG, V/Q, CTPA were observed in both UH andLMWH groups. Data of these above items were statistics analyzed to evaluate the efficiency , safety and cost-effective ratio about UH and LMWH. 3. We use SPSS11.0 software medical statistics to analyze all data, quantitative data analyzed by t-test, qualitative data analyzed by Chi square test, results are regarded as significance difference when P<0. 05 .Results and Discussion1. Comparison of efficiency about UH and LMWH Anticoagulation therapy can avoid embolus forming and recurrence, UHand LMWH are the most commonly used drugs . UH can link to many blood clotting factor including factor II, IX,X, XI, XII, moreover it can link platelet etc. LMWH only links to AT-III . so clotting system is less influenced by LMWH . Many experts put forward that both UH and LMWH can decrease the easily coagulation condition , it is in the same efficiency .but some experts conclude that LMWH is more efficiency than UH.In our study oxygenation index, D-dimer, FG, V/Q, CTPA were observed . Data show that both UH and LMWH are efficient in treating non-massive acute PTE, the efficiency difference is not significant in statistics.2. Comparison of the safety about UH and LMWHUH and LMWH can cause some side effects in coagulation therapy. Bleeding and platelet decreasing are the commonest side effects. Many documents show that Bleeding and platelet decreasing are more common in UH group than LMWH group .The reason of this phenomenon may be that UH links more clotting factors than LMWH. A few studies come to the opposite opinion that bleeding and platelet decreasing ratio are in the same in UH and LMWH group.There are 2 patients presented with bleeding and 2 patients with platelet decreasing in UH group, 1 patient with bleeding and 1 patient with platelet decreasing in LMWH group. The inciden...
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