摘要
目的 探讨利伐沙班在肺栓塞抗凝治疗中的效果及对患者血管内皮功能的影响。方法 70例接受抗凝治疗的肺栓塞患者作为研究对象,应用奇偶分组法分为参照组和试验组,各35例。参照组患者予以华法林治疗,试验组患者予以利伐沙班片治疗。比较两组患者干预前后血管内皮功能指标[血栓素B2(TXB_(2))、内皮素-1(ET-1)、一氧化氮(NO)、可溶性细胞间粘附分子1(sICAM-1)],干预前后凝血功能指标[凝血酶原时间(PT)、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)],干预前后血流动力学指标(心率、呼吸频率、血氧饱和度、血二氧化碳分压、血氧分压)水平。结果 干预前,两组患者的TXB_(2)、ET-1、NO、sICAM-1水平比较差异无统计学意义(P>0.05);干预后,两组NO水平均高于干预前,TXB_(2)、ET-1、sICAM-1水平均低于干预前,且试验组NO(89.27±4.46)μmol/L高于参照组的(84.95±4.18)μmol/L,TXB_(2)(260.72±11.23)μmol/L、ET-1(60.73±5.24)ng/L、sICAM-1(150.31±12.41)μg/L均低于参照组的(287.30±14.18)μmol/L、(67.12±5.18)ng/L、(184.91±14.24)μg/L,差异具有统计学意义(P<0.05)。干预前,两组患者PT、FIB、APTT水平比较差异无统计学意义(P>0.05);干预后,两组PT、APTT均长于本组干预前,FIB低于本组干预前,且试验组PT(15.59±2.27)s、APTT(41.42±4.16)s均长于参照组的(11.45±2.16)、(35.01±3.20)s,FIB(4.70±0.14)g/L低于参照组的(6.36±1.12)g/L,差异具有统计学意义(P<0.05)。干预前,两组患者心率、呼吸频率、血氧饱和度、血二氧化碳分压、血氧分压水平比较差异无统计学意义(P>0.05);干预后,两组患者心率、呼吸频率、血二氧化碳分压水平均低于本组干预前,血氧饱和度、血氧分压水平均高于本组干预前,且试验组患者心率(81.20±4.09)次/min、呼吸频率(21.57±1.10)次/min、血二氧化碳分压(7.01±0.32)kPa均低于参照组的(86.61±3.48)次/min、(25.11±1.07)次/min、(7.47±0.24)kPa,血氧
Objective To discuss the effect of rivaroxaban in anticoagulant therapy for pulmonary embolism and its impact on vascular endothelial function in patients.Methods A total of 70 patients with pulmonary embolism who received anticoagulation therapy were divided into a reference group and an experimental group by parity grouping method,with 35 cases in each group.Patients in the reference group were treated with warfarin,and those in the experimental group were treated with rivaroxaban tablets.Both groups were compared in terms of vascular endothelial function indexes[thromboxane B2(TXB_(2)),endothelin-1(ET-1),nitric oxide(NO),soluble intercellular adhesion molecule-1(sICAM-1)],coagulation function indicators[prothrombin time(PT),fibrinogen(FIB),activated partial thromboplastin time(APTT)]before and after intervention,hemodynamic indicators(heart rate,respiratory rate,blood oxygen saturation,partial pressure of blood carbon dioxide,blood oxygen partial pressure)before and after intervention.Results Before intervention,there was no statistically significant difference in the levels of TXB_(2),ET-1,NO and sICAM-1 between the two groups(P>0.05).After intervention,the level of NO in both groups were higher than that before intervention in this group,and the levels of TXB_(2),ET-1 and sICAM-1 were lower than those before intervention in this group;NO of(89.27±4.46)μmol/L in the experimental group was higher than that of(84.95±4.18)μmol/L in the reference group;the experimental group had TXB_(2) of(260.72±11.23)μmol/L,ET-1 of(60.73±5.24)ng/L,and sICAM-1(150.31±12.41)μg/L,which were lower than those of(287.30±14.18)μmol/L,(67.12±5.18)ng/L,and(184.91±14.24)μg/L in the reference group;the difference were statistically significant(P<0.05).Before intervention,there was no statistically significant difference in PT,FIB and APTT levels between the two groups(P>0.05).After intervention,PT and APTT in both groups were longer than those before intervention in this group,and FIB was lower than that before intervention
作者
管成艳
GUAN Cheng-yan(People's Hospital of Ningjin County,Dezhou 253400,China)
出处
《中国实用医药》
2023年第23期13-17,共5页
China Practical Medicine
关键词
肺栓塞
抗凝治疗
利伐沙班
血管内皮功能
Pulmonary embolism
Anticoagulant therapy
Rivaroxaban
Vascular endothelial function
