利伐沙班治疗静脉血栓栓塞症的初步临床观察  

Efficacy comparison of 3 rivaroxaban regimen in patients with venous thromboembolism

作　　者：周沁[1] 吴艳[2] 蒋鑫[2] 刘兴兰[1] 雷寒[1] 荆志成[2] 黄玮[1] 

机构地区：[1]重庆医科大学附属第一医院心血管内科,400016 [2]中国医学科学院北京协和医学院阜外心血管病医院心血管疾病国家重点实验室血栓性疾病诊治中心

出　　处：《中华心血管病杂志》2015年第9期782-784,共3页Chinese Journal of Cardiology

摘　　要：目的 分析口服不同剂量X因子抑制剂利伐沙班对急性静脉血栓栓塞症患者的疗效和安全性.方法 本研究为回顾性.入选阜外心血管病医院住院的急性静脉血栓栓塞症患者33例,分为3组.组1患者（n=16）起初口服利伐沙班15 mg,每日2次,持续21 d,然后改为20 mg,每日1次.组2患者（n=9）口服利伐沙班20 mg,每日1次.组3患者（n=8）口服利伐沙班10 mg,每日1次.3组患者均连续服药3个月.分析服药3d时D-二聚体下降百分比,D-二聚体下降至正常时间,住院时间,症状缓解时间,服药3个月后影像学复查结果,血栓复发时间,出血事件,肝肾功能指标.结果 组1患者服药第3天D-二聚体下降百分比明显大于组2和组3[（46.12±15.42）％比（26.59±8.11）％和（25.55±14.00）％,P值分别为0.02和0.01].组1患者D-二聚体下降至正常时间明显短于组2和组3[（17.9±7.7）d比（24.1±5.1）d和（26.3±6.2）d,P值分别为0.03和＜0.01].组3有1例患者下肢深静脉血栓复发.组1和组3各1例患者出现严重出血事件.所有患者均未出现严重出血事件和肝肾功能损害.结论 口服利伐沙班15 mg,每日2次,持续21 d,然后改为20 mg,每日1次的治疗方案对急性静脉血栓栓塞症患者的疗效较好,且较为安全.Objective To compare the efficacy and safety of 3 rivaroxaban regimen in patients with venous thromboembolism （VTE）.Methods This is a retrospective study.Thirty three inpatients with VTE received rivaroxaban were divided into 3 groups,in which 16 patients were treated with 15 mg rivaroxaban twice daily for 21 days then followed by 20 mg once per day till 3 months （group 1）,9 patients were treated with 20 mg rivaroxaban once daily for 3 months （group 2）,8 patients were treated with 10 mg rivaroxaban once daily for 3 months.The reduction rate of D-Dimer on the third therapy day,the duration of D-Dimer normalization and hospital stay as well as symptom remission,the imaging assessment results after three months treatment,rate of recurrent VTE,bleeding,liver and kidney function were compared among the 3 groups.Results The reduction rates of D-Dimer on the third therapy day were significantly higher （（46.12±15.42）% vs.（26.59±8.11）% and（25.55 ± 14.00）%,P =0.02,P=0.01）,and the duration of D-Dimer normalization was significantly shorter （（17.9 ±7.7） days vs.（24.1 ±5.1） days and （26.3 ± 6.2） d,P =0.03,P 〈 0.01） in group 1 than in group 2 and 3.There was one recurrent deep-vein thrombosis in group 3,one non-major bleeding in group 1 and group 3.Major bleeding or liver and kidney dysfunction were not observed in these patients.Conclusions Venous thromboembolism can be safely and effectively treated by rivaroxaban,and does of 15 mg twice daily for 21 days followed by 20 mg once daily for 3 months are superior to the other 2 tested therapy regimen in this patient cohort.

关 键 词：血栓栓塞 肺栓塞 抗凝药 

分 类 号：R543.6[医药卫生—心血管疾病]