目的 探讨二乙酰氨乙酸乙二胺联合瑞替普酶对消化道大出血患者纤溶系统的影响。方法 选取2014年8月—2018年1月在青海仁济医院诊治的消化道大出血患者73例，根据治疗方法的不同分为观察组40例与对照组33例，均采用生长抑素治疗方法，对照组给予瑞替普酶静脉溶栓治疗，观察组在对照组治疗基础上给予二乙酰氨乙酸乙二胺治疗，所有患者都用药观察3 d，比较两组临床疗效和止血时间、输血量、住院时间等临床指标的情况，检测D-二聚体和纤维蛋白原（FIB）含量，同时在治疗前后进行血小板黏附率与聚集率的测定。结果 对照组的治疗总有效率为84.8%，观察组为97.5%，观察组显著高于对照组（P<0.05）。观察组的止血时间、输血量、住院时间都显著少于对照组（P<0.05）。观察组治疗后的血小板黏附率、聚集率高于治疗前，也高于对照组，差异均有统计学意义（P<0.05）；对照组治疗后血小板黏附率、聚集率与治疗前比较，差异无统计学意义。经治疗后两组的D-二聚体和FIB值均低于治疗前，同组治疗前后比较差异有统计学意义（P<0.05）；治疗后观察组低于对照组，差异有统计学意义（P<0.05）。结论 二乙酰氨乙酸乙二胺联合瑞替普酶治疗消化道大出血患者能改善纤溶系统的变化，增加血小板活性，从而更加有效发挥止血作用，提高治疗效果。

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.