目的 探讨丹红注射液联合磺达肝癸钠治疗肺栓塞的临床效果。方法 选取2015年1月-2017年12月延安市人民医院收治的肺栓塞患者98例，随机分成对照组（49例）和治疗组（49例）。对照组皮下注射磺达肝癸钠注射液，2.5 mg/次，1次/d，第4天联用华法林进行抗凝治疗，联用5 d，当国际标准化比值（INR）稳定在2~3时，于治疗5 d后停用磺达肝癸钠，继续服用华法林。治疗组在对照组的基础上静脉滴注丹红注射液，20 mL加入250 mL生理盐水，1次/d。两组均连续治疗14 d。观察两组患者临床疗效，同时比较治疗前后两组患者主要症状缓解时间、动脉血氧分压（pO₂）值、肺动脉阻塞指数（PAOI）、肺动脉收缩压（PASP）、心肌肌钙蛋白I（cTnI）、右室舒张末期内径（RVd）、凝血酶原时间（PT）、血小板计数（PLT）、纤维蛋白原降解产物（FDP）、D-二聚体（D-D）、补体C3、白细胞介素-6（IL-6）及外周血CD4⁺/CD8⁺、CD3⁺水平。结果 治疗后，对照组临床有效率为71.4%，显著低于治疗组的87.8%，两组比较差异具有统计学意义（P<0.05）。治疗后，治疗组患者发绀、胸痛和呼吸困难缓解时间均显著短于对照组（P<0.05）。治疗后，两组pO₂值较治疗前均显著增加（P<0.01），PAOI、PASP、RVd值和血清cTnI水平均显著降低（P<0.01），且治疗后治疗组pO₂、PAOI、PASP、RVd值和血清cTnI明显优于对照组（P<0.01）。治疗后，两组PT、PLT值均显著升高（P<0.01），血清FDP、D-D水平显著下降（P<0.01），且治疗后治疗组上述凝血-纤溶指标明显优于对照组（P<0.01）。治疗后，两组血清补体C3、IL-6水平及外周血CD4⁺/CD8⁺比值较治疗前明显降低（P<0.05），外周血CD3⁺值均明显升高（P<0.05），且治疗后治疗组免疫学指标明显优于对照组（P<0.05）。结论 丹红注射液联合磺达肝癸钠治疗肺栓塞可明显改善患者病情，调控体内凝血-纤溶系统，抑制炎性反应，调节细胞免疫，疗效显著。

Objective To investigate the clinical effect of Danhong Injection combined with fondaparinux sodium in treatment of pulmonary embolism. Methods Patients (98 cases) with pulmonary embolism in Yan'an People's Hospital from January 2015 to December 2017 were randomly divided into control (49 cases) and treatment (49 cases) groups. Patients in the control group were sc administered with Fondaparinux Sodium Injection, 2.5 mg/time, once daily, and combined with warfarin anticoagulation therapy at the fourth day, and combined application for 5 d, when the INR value is stabilized in 2-3 for 5 d, then discontinued Fondaparinux Sodium Injection. Patients in the treatment group were iv administered with Danhong Injection on the basis of the control group, 20 mL added into normal saline 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the remission times of clinical symptoms, pO₂, PAOI, PASP, cTnI, RVd, PT, PLT, FDP, D-D, complement C3, IL-6, CD4⁺/CD8⁺, and CD3⁺ of peripheral blood in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 71.4%, which was significantly lower than 87.8% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the remission times of cyanosis, chest pain, and dyspnea in the treatment group were significantly shorter than those in the control group (P<0.01). After treatment, pO₂ in two groups was significantly increased (P<0.01), and PAOI, PASP, RVd value, and serum cTnI levels were significantly decreased (P<0.05), and these indicators in the treatment group were significantly better than those in the control group (P<0.01). After treatment, PT and PLT value in two groups was significantly increased (P<0.01), and serum FDP and D-D levels were significantly decreased (P<0.01), and the coagulation and fibrinolysis indicators in the treatment group were significantly better than those in the control group (P<0.01). After treatment, the complement C3, IL-6, and CD4⁺/CD8⁺ of peripheral blood in two groups were significantly decreased (P<0.05), and CD3⁺ of peripheral blood was significantly increased (P<0.05), and the immunological indicators in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Danhong Injection combined with fondaparinux sodium in treatment of pulmonary embolism can significantly improve the patient's condition, regulate the coagulation-fibrinolysis system, inhibit the inflammatory reaction and regulate the cellular immunity, which has remarkable curative effect.