摘要
目的分析利伐沙班联合导管溶栓在老年颅内出血患者急性上肢深静脉血栓形成的血小板淋巴细胞比率及预后影响。方法选取南京医科大学第一附属医院2018年10月~2022年9月收治的老年颅内出血并发急性上肢深静脉血栓患者43例导管拔除后予以利伐沙班口服的患者作为观察组,并选取同期43例单纯溶栓患者为对照组。评估观察两组患者治疗后的临床疗效、血小板淋巴细胞比率(PLR)等情况。结果观察组总有效率93.02%(4043)显著高于对照组79.07%(3143),差异有统计学意义(χ2=4.038,P<0.05)。观察组血浆二聚体(D-D)、纤维蛋白原(Fib)、PLR均显著低于对照组[(0.71±0.14)mg L vs.(0.83±0.22)mg L、(3.52±0.38)g L vs.(4.37±0.42)g L、(220.83±53.1)vs.(281.12±89.73)],凝血酶原时间(PT)、活化部分凝血酶时间(APTT)均显著高于对照组[(15.14±1.31)s vs.(14.18±1.52)s、(44.29±4.53)s vs.(40.28±4.17)s],差异均有统计学意义(t=3.018、9.841、3.784、3.137、4.271,P<0.05)。治疗2周后,观察组患肢与健肢肘上、肘下20 cm处周径差值显著低于对照组[(1.52±0.23)cm vs.(1.83±0.27)cm、(1.02±0.12)cm vs.(1.69±0.35)cm],差异均有统计学意义(t=5.731、11.874,P<0.05)。观察组不良反应发生率低于对照组,但差异无统计学意义(P>0.05)。结论利伐沙班联合导管溶栓治疗急性上肢深静脉血栓,可以取得一定的临床疗效,DVT形成的生理机制与PLR相关,PLR指标对DVT的形成及预后评估有帮助。
Objective To analyze platelet lymphocyte ratio(PLR)and prognostic impact of sandbath combined with catheter thrombolysis in elderly patients with acute upper extremity deep vein thrombosis(DVT)complicating intracranial hemorrhage.Methods Aged patients with intracranial hemorrhage combined with acute upper extremity DVTs admitted to our hospital from October 2018 to September 2022 were selected.Based on the inclusion and exclusion criteria,43 patients who took rivoroxaban orally after catheter removal were selected as the observation group,and 43 patients who received thrombolysis alone during the same period were selected as the control group.Clinical efficacy and PLR were evaluated and compared after treatment.Results The overall efficacy of 93.02%(4043)was significantly higher in the observation group than in the control group(3143)(χ^(2)=4.038,P<0.05).The levels of plasma D-D(D-dimer),FIB(Fibrinogen)and PLR in the observation group were significantly lower than those in the control group[(0.71±0.14)mg L vs.(0.83±0.22)mg l,(3.52±0.38)g L vs.(4.37±0.42)g l,(220.83±53.1)vs.(281.12±89.73)],prothrombin time(PT)and activated partial thromboplastin time(APTT)were significantly higher than those in the control group[(15.14±1.31)s vs.(14.18±1.52)s,(44.29±4.53)s vs.(40.28±4.17)s],the difference was significant(t=3.018,9.841,3.784,3.137,4.271,P<0.05).After 2 weeks of treatment,the limb circumference diameter and above the elbow in the observation group were significantly lower than in the control group[(1.52±0.23)cm vs.(1.83±0.27)cm,(1.02±0.12)cm vs.(1.69±0.35)cm](t=5.731,11.874,P<0.05).The incidence of adverse reactions was lower than in the control group,with no statistical significance(P>0.05).Conclusion Livoxaban combined with catheter thrombolysis is effective in the treatment of acute upper extremity DVT.The physiological mechanism of DVT formation is related to PLR,and PLR index is helpful for the evaluation of DVT's formation and prognosis.
作者
唐玥
田雅丽
颜伟
吴娟
Tang Yue;Tian Yali;Yan Wei(Emergency Intensive Care Unit,the First Affiliated Hospital With Nanjing Medical University,Jiangsu Province Hospital,Nanjing 210000,China)
出处
《中华保健医学杂志》
2024年第1期22-25,共4页
Chinese Journal of Health Care and Medicine
基金
江苏省第十五批“六大人才高峰”高层次人才选拔培养资助项目(WSW-006)。
关键词
老年颅内出血患者
急性上肢深静脉血栓
血小板淋巴细胞比率
Intracranial hemorrhage old age
Acute upper extremity deep vein thrombosis
Platelet lymphocyte ratio
