目的 探討二乙酰氨乙酸乙二胺聯(lián)合瑞替普酶對消化道大出血患者纖溶系統(tǒng)的影響。方法 選取2014年8月—2018年1月在青海仁濟醫(yī)院診治的消化道大出血患者73例，根據(jù)治療方法的不同分為觀察組40例與對照組33例，均采用生長抑素治療方法，對照組給予瑞替普酶靜脈溶栓治療，觀察組在對照組治療基礎(chǔ)上給予二乙酰氨乙酸乙二胺治療，所有患者都用藥觀察3 d，比較兩組臨床療效和止血時間、輸血量、住院時間等臨床指標(biāo)的情況，檢測D-二聚體和纖維蛋白原（FIB）含量，同時在治療前后進行血小板黏附率與聚集率的測定。結(jié)果 對照組的治療總有效率為84.8%，觀察組為97.5%，觀察組顯著高于對照組（P<0.05）。觀察組的止血時間、輸血量、住院時間都顯著少于對照組（P<0.05）。觀察組治療后的血小板黏附率、聚集率高于治療前，也高于對照組，差異均有統(tǒng)計學(xué)意義（P<0.05）；對照組治療后血小板黏附率、聚集率與治療前比較，差異無統(tǒng)計學(xué)意義。經(jīng)治療后兩組的D-二聚體和FIB值均低于治療前，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；治療后觀察組低于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 二乙酰氨乙酸乙二胺聯(lián)合瑞替普酶治療消化道大出血患者能改善纖溶系統(tǒng)的變化，增加血小板活性，從而更加有效發(fā)揮止血作用，提高治療效果。

Objective To investigate the effects ofethy enediamine diaceturate combined with leipeptase on fibrinolytic system in patients with massive hemorrhage of digestive tract combined with reteplase on fibrinolytic system in patients with massive gastrointestinal hemorrhage.Methods From August 2014 to January 2018, 73 patients with massive hemorrhage of digestive tract were selected in our hospital and divided into the 40 cases in the observation group and 33 cases in the control group accorded to the different treatment methods. The two groups were treated with somatostatin, the control group were treated with intravenous thrombolytic therapy withleipeptase, and the observation group were treated ethy enediamine diaceturate combined with leipeptase. The changes of fibrinolytic system were recorded.Results The total effective rates of the control group were 84.8%, while that of the observation group were 97.5%, and the observation group were significantly higher than that of the control group (P<0.05). The hemostasis time, blood transfusion volume and hospitalization time in the observation group were significantly less than those in the control group (P<0.05). The platelet adhesion rate and aggregation rate of the observation group were higher than those in the control group, and compared the difference were statistically significantly (P<0.05). There were no significant difference between the control group before and after treatment (P<0.05). After treatment, the D-Dimer and FIB values of the two groups were lower than those before treatment, while those of the observation group were lower than those of the control group (P<0.05).Conclusion The ethy enediamine diaceturate combined with reiplase can improve the changes of fibrinolytic system and increase the activity of platelet, so as to improve the effect of hemostasis and improve the therapeutic effect.