低分子肝素钙联合利伐沙班治疗急性肺栓塞的效果及对凝血功能、血管内皮功能的影响被引量：42

Efficacy of Low-molecular-weight Heparin Calcium Combined with Rivaroxaban in Treatment of Patients with Acute Pulmonary Embolism and Its Effects on Coagulation Function and Vascular Endothelial Function

在线阅读下载PDF

导出

摘要目的探讨低分子肝素钙联合利伐沙班治疗急性肺栓塞的效果及对凝血功能、血管内皮功能的影响。方法选取2018年11月—2020年9月收治的急性肺栓塞患者113例。据治疗方法的不同分为研究组59例和对照组54例,对照组采用低分子肝素钙联合华法林治疗,研究组采用低分子肝素钙联合利伐沙班治疗。治疗3个月后比较两组疗效,呼吸困难、胸痛、发绀症状消失时间,治疗前后凝血酶原时间(PT)、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占预计值百分比(FEV1%)、用力肺活量占预计值百分比(FVC%)、可溶性细胞间黏附分子-1(sICAM-1)、内皮素-1(ET-1)、血栓素B 2(TXB 2)及一氧化氮(NO)水平,以及治疗期间不良反应发生情况。结果治疗3个月后,研究组总有效率高于对照组(P<0.01)。研究组呼吸困难、胸痛、发绀症状消失时间均短于对照组(P<0.01)。治疗后,两组PT、APTT、FEV1、FEV1%、FVC%及NO较治疗前升高,FIB、sICAM-1、ET-1、TXB 2较治疗前降低,且研究组PT、APTT、FEV1、FEV1%、FVC%、NO升高程度,以及FIB、sICAM-1、ET-1、TXB 2降低程度均大于对照组(P<0.05,P<0.01)。治疗期间,研究组不良反应总发生率低于对照组(P<0.05)。结论低分子肝素钙联合利伐沙班治疗急性肺栓塞效果显著,可有效缩短症状消失时间,改善凝血功能、肺功能和血管内皮功能,并减少不良反应发生。 Objective To investigate efficacy of low-molecular-weight heparin calcium(LMWH-Ca)combined with Rivaroxaban in treatment of patients with acute pulmonary embolism(APE)and its effects on coagulation function and vascular endothelial function.Methods A total of 113 patients with APE during November 2018 and September 2020 were selected,and the patients were divided into research group(n=59)and control group(n=54)according to different treatment methods.Control group was treated with LMWH-Ca combined with Warfarin,while research group was treated with LMWH-Ca combined with Rivaroxaban.After 3 months of treatment,curative effect,disappearance times of dyspnea,chest pain and cyanosis symptoms were compared,and levels of prothrombin time(PT),fibrinogen(FIB),activated partial thromboplastin time(APTT),forced expiratory volume in the first second(FEV1),percentage of forced expiratory volume in one second to expected value(FEV1%),percentage of forced vital capacity to predicted value(FVC%),soluble intercellular adhesion molecule-1(sICAM-1),endothelin-1(ET-1),thromboxane B 2(TXB 2)and nitric oxide(NO)before and after treatment were also observed,and incidence rates of adverse reactions during treatment were recorded in two groups.Results After 3 months of treatment,the total effective rate in research group was significantly higher than that in control group(P<0.01).Disappearance times of dyspnea,chest pain and cyanosis in research group were significantly shorter than those in control group(P<0.01).After treatment,levels of PT,APTT,FEV1,FEV1%,FVC%and NO were significantly higher,while levels of FIB,sICAM-1,ET-1 and TXB 2 were significantly lower than those before treatment in two groups;increased degrees of PT,APTT,FEV1,FEV1%,FVC%and NO and decreased degrees of FIB,sICAM-1,ET-1 and TXB 2 in research group were greater compared with those in control group(P<0.05,P<0.01).During the treatment,the total incidence rate of adverse reactions in research group was lower than that in control group(P<0.05).Conclusion LMWH-Ca combined with Rivaroxaban has significant efficacy in treatment of APE patients,and it may effectively shorten time of symptom disappearance,improve coagulation function,pulmonary function and vascular endothelial function and reduce adverse reactions.

作者焦建华李霞 JIAO Jian-hua;LI Xia(Department of Respiratory Medicine,the First Hospital of Zhangjiakou City,Zhangjiakou,Hebei 075000,China)

机构地区张家口市第一医院呼吸内科

出处《临床误诊误治》 CAS 2021年第6期49-54,共6页 Clinical Misdiagnosis & Mistherapy

基金河北省医学科学研究重点课题计划项目(20191721) 张家口市2018年度市级科技计划自筹经费项目(1821095D)。

关键词急性肺栓塞低分子肝素钙利伐沙班凝血酶原时间纤维蛋白原第1秒用力呼气容积内皮素-1 不良反应 Acute pulmonary embolism Low molecular weight heparin calcium Rivaroxaban Prothrombin time Fibrinogen Forced expiratory volume in the first second Endothelin-1 Adverse reaction

分类号 R563.5 [医药卫生—呼吸系统]

作者简介焦建华,本科,主治医师。主要从事呼吸内科方向研究。