摘要
目的探讨血栓弹力图(TEG)对利伐沙班抗凝疗效的监测作用。方法选择2017年3月至2017年11月在山西大医院血管外科住院并确诊为急性下肢深静脉血栓形成(DVT)的患者80例,患者的抗凝方案均为常规口服利伐沙班,随访3个月,未发生大出血、重要脏器部位的出血及血栓复发等不良事件。采用单因素重复测量方差分析比较患者在四个不同时间段(抗凝治疗前、口服利伐沙班后3 d、1个月及3个月)的凝血功能[凝血酶原时间(PT)、活化部分凝血激酶时间(APTT)、纤维蛋白原(Fib)及D-二聚体]及TEG(R值、K值、Angle角、MA值)的变化。结果用药后(口服利伐沙班后3 d、1个月及3个月)的R值、K值、PT值增大,D-二聚体值减小,与抗凝治疗前比较,差异有统计学意义(P均<0.05);而Fib、APTT、Angle角、MA值抗凝治疗前、后比较,差异无统计学意义(P>0.05)。PT、R值、K值在服药后3 d、1个月、3个月分别两两比较,差异无统计学意义(P>0.05)。结论TEG检测方法简单快捷,准确度高,TEG检测指标(R值、K值)可以作为一种监测利伐沙班抗凝疗效的手段。
Objective To investigate the effect of thrombelastography(TEG)on the anticoagulant efficacy of rivaroxaban by dynamically detecting common coagulation function and TEG at different time intervals before and after oral administration of rivaroxaban in patients with venous thromboembolism(VTE).Methods A total of 80 patients with a diagnosis of acute lower extremities deep vein thrombosis(DVT)who were admitted to the department of vascular surgery,Shanxi Dayi Hospital during March 2017 to November 2017 were enrolled into this study.All patients received routine rivaroxaban tablets orally for their out-of-hospital anticoagulation regimens.During three months of follow-up,no massive haemorrhage or visceral haemorrhage or recurrence of thrombosis event occurred.Univariate analysis was conducted to analyze the changes of coagulation test and TEG among four different time points(pre-coagulation,three days-,one month-and three month after rivaroxaban coagulation therapy).Results R value,K value,and PT value were significantly increased while D-dimer value was decreased after administrated of rivaroxaban compared with pre-coagulation(P<0.05).There was no significant difference of Fib,APTT,Angle angle and MA value between pre-and post-coagulation therapy(P>0.05).In comparison among different time points post-coagulation,there was no significant difference of PT,R and K values in each groups(P>0.05).Conclusions R value and K value of TEG test are prolonged after oral administration of rivaroxaban in patients with VTE,which can be used as a means to monitor the anticoagulation efficacy of rivaroxaban.
作者
刘佳豪
杨涛
续慧民
郝斌
Liu Jiahao;Yang Tao;Xu Huimin;Hao Bin(Department of Vascular Surgery,Shanxi Academy of Medical Science Shanxi Dayi Hospital,Taiyuan 030032,China)
出处
《中华血管外科杂志》
2019年第2期102-106,共5页
Chinese Journal of Vascular Surgery
基金
山西省卫生计生委科研课题(2017009)
山西省科技厅2015软科学研究项目(2015041038-3).
关键词
利伐沙班
抗凝
凝血监测
血栓弹力图
Rivaroxaban
Anticoagulation
Coagulation monitoring
Thrombelastography
