摘要
目的探讨利伐沙班用于急性肺栓塞的临床疗效及其对血管内皮功能的影响。方法选择急性肺栓塞病人46例,以随机软件进行随机,分为利伐沙班组(25例)和华法林组(21例),两组病人均皮下注射低分子肝素钙,利伐沙班组在此基础上服用利伐沙班,华法林组在此基础上服用华法林,治疗6个月后,比较两组病人的临床疗效和不良反应,同时对治疗前后两组病人呼吸速率、心率、动脉血氧分压(PaO_2)、D-二聚体、血浆蛋白C(PC)、血浆蛋白S(PS)、内皮素-1(ET-1)、组织型纤溶酶原激活物(t-PA)、血栓素B2(TXB2)、前列环素(6-k-p GF1a)和一氧化氮(NO)水平进行比较。结果治疗后,利伐沙班组和华法林组病人呼吸速率、心率、D-二聚体、PC、PS、ET-1、t-PA、TXB2均明显降低,PaO_2、6-k-p GF1a和NO水平明显升高,与治疗前比较差异有统计学意义(P<0.05)。且治疗后利伐沙班组和华法林组病人的呼吸速率、心率、Pa O_2、D-二聚体、PC、PS、ET-1、t-PA、TXB2、6-k-p GF1a和NO水平均差异无统计学意义(P>0.05)。利伐沙班组和华法林组治疗的总有效率差异无统计学意义(χ2=0.439,P=0.686),而利伐沙班组的不良反应发生率低于华法林组的不良反应发生率,差异有统计学意义(χ~2=6.678,P=0.015)。结论利伐沙班对急性肺栓塞具有明显的治疗效果,使用方便且不良反应小。
Objective To investigate the clinical efficacy of rivaroxaban on acute pulmonary embolism and its effect on vascular endo-thelial function. Methods 46 patients with acute pulmonary embolism treated in our hospital were admitted. 46 patients were randomly divided into the rivaroxaban group （ n= 25） and warfarin group （n= 21）. 46 patients were given subcutaneous injection of low molecu-lar weight heparin calcium. Then the rivaroxaban group were given rivaroxaban and the warfarin group were given warfarin for 6 months. The clinical effect and adverse reaction in two groups were compared. Meanwhile,the espiratory rate,heart rate,arterial partial pressure of oxygen （PaO2） , D-dimer, plasma protein C （ PC ） , plasma protein S （ PS）,endothelin 1 （ ET-1） , tissue type plasminogen activator （t-PA） , thromboxane B2 （TXB2） ,prostacyclin （6-k-pGFla） and nitric oxide （NO） before and after treatment in the two groups were compared. Results After treatment,respiratory rate,heart rate,D-dimer,PC,PS,ET-1 ,t-PA and TXB2 in two groups were decreased and the PaO2 and lev-els of 6-k-pGF1α and NO were significantly increased, suggesting statistical significance compared with that before treatment （ P 〈0. 05 ） . However,these index after treatment in two groups were not significantly different （ P 〉 0. 05 ） . The total efficiency in two groups was not statistically significant（X2 =0. 439 ,P =0. 686 ）. The occurrence rate of adverse reactions in the rivaroxaban group is lower than that in the warfarin group,showing statistically significant difference （X2=6. 61%,P =0.015 ） . Conclusion Rivaroxaban can signifi-cantly improve the clinical indicators of acute pulmonary embolism. And it is easy to use and has obvious therapeutic effect on acute pulmonary embolism with little adverse reactions.
出处
《安徽医药》
CAS
2017年第2期349-352,共4页
Anhui Medical and Pharmaceutical Journal
关键词
利伐沙班
急性肺栓塞
抗凝
临床观察
Rivaroxaban
Acute pulmonary embolism
Anticoagulation
Clinical observation
