Pulmonary Thrombo Embolism: A Comparison Of Blood Coagulation Factor And Therapy Effect Between Different Danger Groups With The Thrombolytic Therapy

Background：Pulmonary thrombo embolism(PTE)is a disease or syndrome thatpulmonary arteries or its branches are obstructed by thrombosis from theVenous system or right heart．Thrombolytic therapy can more rapidly reducepulmonary thromboembolism in patients with pulmonary mechanicalobstruction，improve pulmonary hemodynamics, reduce the mortality ofpatients. However，the differences and similarities of clinical featuresand treatment effect between PTE patients of different groups,and improvethe acknowledge of clinicians to PTE,which has an actrual values.Objectives：To observe the changes of fibrinogen、fibrin degradationproduct、D-dimer、platelet and different treatment effect of differentgroups with thrombolytic therapy， understanding of the variouscoagulation indicators before and after pulmonary embolism thrombolytictherapy, the relationship between treatment effect and risk of differentrisk groups before and after thrombolytic therapy,referring to providesome micro indicators and to provide a reference therapeutic dose forthe different risk groups.Materials and Methods：This is a restrospective study for PTE．64patientsin Fujian province hospital diagnosed as PTE from2004.1to2011.10，are divided into two groups：the high-risk group and the middle-risk groupaccording to the The2008European pulmonary embolism diagnosis andtreatment guidelines.Keep detailed records of gender,age,history ofsecondary risk factors，clinical symptoms,signs and laboratory quota thencompare similarities and differences between two groups with the methodsof statistics，using matched t-test and two group t-test and Chi-squaretest for quantitative data； using Mann-Whitney U test forsemi-quantitative data，when P<0.05，it make sense.Results：In the results of two groups,we can find that: (1)There is no significantly difference between two groups’fibrinogenbefore thrombolytic therapy（P>0.05）；After thrombolytic therapy,twogroups’ fibrinogen both significantly lower than before（P<0.05）,andthe middle-risk group’s fibrinogen is significantly lower than thehigh-risk one（P<0.05）.(2)There is no significantly difference between two groups’ fibrindegradation product (FDP)before thrombolytic therapy（P>0.05）, after thethombolytic therapy both groups’FDP are higher than before,themiddle-risk group have significance, high-risk group have no significanceand after the thombolytic therapy, there is no significantly differencebetween two groups’ FDP（P>0.05）.(3)There is no significantly difference between two groups’ D-dimerbefore thrombolytic therapy (P>0.05)； after thrombolytic therapygroups’fibrinogen both significantly lower than before(P<0.05).and themiddle-risk groups’fibrinogen is significantly lower than high-risk one(P<0.05).(4)There is no significantly difference between two groups’ plateletbefore thrombolytic therapy (P>0.05);after thrombolytic therapy,twogroups’ platelet both significantly higher than before（P<0.05）,and themiddle-risk group’s fibrinogen is significantly higher than thehigh-risk one（P<0.05）.(5)The middle-risk group’s treatment effect have an advantage overhigh-risk group’s.Conclusion：(1)The middle-risk group’s coagulation-related indicatorshave some significantly change to the high-risk one.(2)The middle-risk group have ideal thrombolytic response and treatmentto high-risk one.(3)Risk stratification in the judgment of thrombolytic therapy inpatients with pulmonary thromboembolism have a certain reference value, but it need more investigation about the change of the doses aboutthrombolytics.In this study, due to the limited number of cases, the results may haveerrors.