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目的：观察加用降纤酶治疗对提高中晚期慢性阻塞性肺疾病（ＣＯＰＤ）疗效的影响。方法：将５８例中晚期ＣＯＰＤ患者随机分为２组。对照组２８例采用抗炎、化痰、吸氧、扩张支气管及强心等常规治疗，治疗组３０例在常规治疗基础上加用降纤酶５Ｕ加入２００ｍｌ生理盐水中静滴，每日１次，疗程为３日。观察２组症状、体征及动脉血气、纤维蛋白原等指标的改善情况。结果：治疗３日后治疗组的症状缓解率（１００．０％）、干、湿性口罗音消失或明显减少所需时间〔（５．０６±１．０８）日〕、动脉血氧分压〔（８．６７±１．２１）ｋＰａ，１ｋＰａ＝７．５ｍｍＨｇ〕、动脉血二氧化碳分压〔（６．０３±０．０８）ｋＰａ〕、纤维蛋白原含量〔（３．３４±０．５３）ｇ／Ｌ〕、治疗后Ｘ线胸片改善率（９０．０％）及平均住院日（７日）较对照组〔分别为７８．６％，（１２．０１±１．９８）日，（７．２０±１．９８）ｋＰａ，（６．９７±０．１４）ｋＰａ，（５．６０±０．７７）ｇ／Ｌ，６４．３％和１２日〕均显著改善（Ｐ＜０．０５或Ｐ＜０．０１）。结论：降纤酶可有效地降低血纤维蛋白原浓度，改善肺内微循环，对中晚期ＣＯＰＤ患者加用降纤酶治疗有明显疗效
Objective: To observe the effect of adding defibrase on improving the curative effect of chronic obstructive pulmonary disease (COPD). Methods: Fifty-eight patients with advanced and middle-stage COPD were randomly divided into two groups. Control group, 28 cases of anti-inflammatory, phlegm, oxygen, bronchiectasis and cardiac expansion and other conventional treatment group 30 patients on the basis of conventional treatment plus defibrase 5U added 200ml saline intravenously once daily , Treatment for 3 days. Two groups of symptoms, signs and arterial blood gas, fibrinogen and other indicators of improvement. Results: After 3 days of treatment, the rate of symptom relief (100.0%), the time required for the disappearance or significant reduction of dry and wet oral rales (5.06 ± 1.08 days), the partial pressure of arterial oxygen (8.67 ± 1.21) kPa, 1kPa = 7.5mmHg], partial pressure of arterial carbon dioxide 〔(6.03 ± 0.08) kPa〕, fibrinogen content 〔(3.34 ± 0.53) (90.0%) and average length of stay (7 days) were significantly lower than those in the control group [78.6% (12.01 ± 1.98) days, 7.20 ± 1.98 kPa, 6.97 ± 0.14 kPa, 5.60 ± 0.77 g / L, 64.3% and 12 days, respectively) were significantly improved (P <0. 05 or P <0.01). Conclusion: Defibrase can effectively reduce the concentration of fibrinogen and improve microcirculation in the lung, and it has a significant effect on the treatment of middle and late COPD patients with defibrase