摘要
目的:探究低分子量肝素钙联合利伐沙班治疗急性肺血栓栓塞症(APE)的临床效果,并观察其对凝血纤溶和血小板活化的影响。方法:选择2019年1月—2023年1月在石狮市医院呼吸与危重症医学科治疗的100例APE患者作为研究,应用随机数表法将患者分为对照组(低分子量肝素钙联合华法林)及观察组(低分子量肝素钙联合利伐沙班),各50例。对比两组临床疗效、炎症因子[肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、N末端脑钠肽前体(NT-proBNP)]、血管内皮功能[可溶性细胞间黏附分子1(sICAM-1)、内皮素1(ET-1)、血栓素B2(TXB2)]、凝血纤溶指标[蛋白C(PC)、蛋白S(PS)、D-二聚体(D-D)]、血小板活化指标[血小板膜糖蛋白Ⅱb/Ⅲa(GPⅡb/Ⅲa)、P-选择素(P-selectin)、血管紧张素Ⅱ(AngⅡ)、血管性血友病因子(vWF)]。结果:对照组治疗总有效率低于观察组,差异有统计学意义(P<0.05)。两组治疗前炎症因子水平、血管内皮功能、凝血纤溶指标、血小板活化指标比较,差异无统计学意义(P>0.05);观察组治疗后TNF-α、hs-CRP、NT-proBNP、sICAM-1、ET-1、TXB2、PS、PC、D-D、GPⅡb/Ⅲa、P-selectin、AngⅡ、vWF水平低于对照组,差异有统计学意义(P<0.05)。结论:低分子量肝素钙联合利伐沙班治疗APE,可减轻炎症反应,改善血管内皮、凝血纤溶功能,降低血小板活化因子水平,效果显著。
Objective:To investigate the clinical effect of Low Molecular Weight Heparin Calcium combined with Rivaroxaban in the treatment of acute pulmonary thromboembolism(APE),and to observe its influence on coagulation fibrinolysis and platelet activation.Method:A total of 100 patients with APE who treated in the Department of Respiratory and Critical Care Medicine of Shishi Hospital from January 2019 to January 2023 were selected as the study subjects,the patients were divided into the control group(Low Molecular Weight Heparin Calcium combined with Warfarin)and observation group(Low Molecular Weight Heparin Calcium combined with Rivaroxaban)by random number table method,50 cases in each group.The clinical efficacy,inflammatory factors[tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP),N-terminal pro-brain natriuretic peptide(NT-proBNP)],vascular endothelial function[soluble intercellular adhesion molecule 1(sICAM-1),endothelin 1(ET-1),thromboxane B2(TXB2)],coagulation and fibrinolysis indicators[protein C(PC),protein S(PS),D-dimer(D-D)],platelet activation indicators[platelet membrane glycoproteinⅡb/Ⅲa(GPⅡb/Ⅲa),P-selectin(P-selectin),angiotensinⅡ(AngⅡ),von Willebrand factor(vWF)]were compared between two groups.Result:The total effective rate of the control group was lower than that of the observation group,and the difference was statistically significant(P<0.05).There were no significant differences in the levels of inflammatory factors,vascular endothelial function,coagulation and fibrinolysis indicators and platelet activation indicators between two groups before treatment(P>0.05);the levels of TNF-α,hs-CRP,NT-proBNP,sICAM-1,ET-1,TXB2,PS,PC,D-D,GPⅡb/Ⅲa,P-selectin,AngⅡand vWF in the observation group after treatment were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:Low Molecular Weight Heparin Calcium combined with Rivaroxaban in the treatment of APE can reduce inflammatory reaction,improve vascular endothelia
作者
林火
杨凡
蔡茂胜
LIN Huo;YANG Fan;CAI Maosheng(Shishi Hospital,Shishi 362700,China;不详)
出处
《中外医学研究》
2024年第2期57-61,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
利伐沙班
低分子量肝素钙
急性肺血栓栓塞症
凝血纤溶
血小板活化
Rivaroxaban
Low Molecular Weight Heparin Calcium
Acute pulmonary thromboembolism
Coagulation fibrinolysis
Platelet activation
