摘要
目的探讨华法林、利伐沙班治疗慢阻肺合并急性中危肺栓塞、肺高压的疗效。方法纳入2019年1月—2021年7月定西市人民医院80例慢阻肺并急性中危肺栓塞、肺高压患者为研究对象,根据随机数表法分为华法林组和利伐沙班组,各40例。比较两组凝血指标、血气分析指标、治疗有效率及不良反应发生情况。结果治疗后,利伐沙班组凝血酶原时间、活化部分凝血活酶时间较华法林组更短,D-二聚体水平较华法林组更低,血小板计数较华法林组更高,差异有统计学意义(P<0.05)。治疗后,利伐沙班组动脉氧分压较华法林组更高,肺动脉压、动脉血二氧化碳分压较华法林组更低,差异有统计学意义(P<0.05)。利伐沙班组治疗有效率较华法林组更高,差异有统计学意义(P<0.05)。两组患者不良反应发生情况比较,差异无统计学意义(P>0.05)。结论与华法林相比,利伐沙班治疗慢阻肺并急性中危肺栓塞、肺高压患者时的抗凝效果更理想,对血气分析指标有更积极的影响,但两种药物的不良反应差异不大。
Objective To investigate the efficacy of warfarin and rivaroxaban in the treatment of COPD complicated with acute intermediate-risk pulmonary embolism and pulmonary hypertension.Methods From January 2019 to July 2021,80 patients with COPD,acute intermediate-risk pulmonary embolism and pulmonary hypertension in Dingxi People's Hospital were enrolled as research subjects,and 40 cases were divided into warfarin group and rivaroxaban group according to random number table method.The coagulation indexes,blood gas analysis indexes,treatment efficacy rate and occurrence of adverse reactions were compared between the two groups.Results After treatment,the prothrombin time and activated partial thromboplastin time of rivaroxaban group were shorter than those in warfarin group,D-dimer levels were lower than that in warfarin group,and platelet count was higher than that in warfarin group,and the difference was statistically significant(P<0.05).After treatment,the partial pressure of arterial oxygen in the rivaroxaban group was higher than that in the warfarin group,and the partial pressure of pulmonary artery and arterial blood carbon dioxide were lower than those in the warfarin group,and the difference was statistically significant(P<0.05).The treatment response rate of rivaroxaban group was higher than that in the warfarin group,and the difference was statistically significant(P<0.05).There was no statistically significant of the occurrence of adverse reactions in the two groups(P>0.05).Conclusion Compared with warfarin,rivaroxaban has a more ideal anticoagulation effect in the treatment of patients with COPD and acute intermediate-risk pulmonary embolism and pulmonary hypertension,and has a more positive effect on blood gas analysis indexes,but the adverse reactions of the two drugs are not much different.
作者
赵信燕
岳晓霞
曹瑞玲
张惠丽
李向杰
吴懿
ZHAO Xinyan;YUE Xiaoxia;CAO Ruiling;ZHANG Huili;LI Xiangjie;WU Yi(Department of Respiratory and Critical Care Medicine,Dingxi People's Hospital,Dingxi,Gansu Province,743000 China)
出处
《系统医学》
2023年第7期121-125,共5页
Systems Medicine
基金
定西市科技成果管理计划项目(国统制[2017]4号)。
关键词
慢阻肺
急性中危肺栓塞
肺高压
华法林
利伐沙班
凝血指标
血气分析
Chronic obstructive pulmonary disease
Acute intermediate risk pulmonary embolism
Pulmonary hypertension
Warfarin
Rivaroxaban
Coagulation indexes
Blood gas analysis
