丹红注射液联合利伐沙班治疗急性肺栓塞的临床疗效及其对凝血功能、血管内皮功能、炎性反应的影响  

Clinical Efficacy of Danhong Injection Combined with Rivaroxaban in the Treatment of Acute Pulmonary Embolism and Its Effect on Blood Clotting Function,Vascular Endothelial Function and Inflammatory Reaction

作　　者：柴海强 CHAI Haiqiang(Department of Respiratory Medicine,Chang'an Hospital,Xi'an 710016,China)

机构地区：[1]长安医院呼吸科,陕西省西安市710016

出　　处：《实用心脑肺血管病杂志》2019年第1期70-74,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨丹红注射液联合利伐沙班治疗急性肺栓塞(APE)的临床疗效,并分析其对凝血功能、血管内皮功能、炎性反应的影响。方法选取2014年3月—2018年4月西安市长安医院收治的APE患者80例,采用随机数字表法分为对照组和观察组,每组40例。在常规治疗基础上,对照组患者给予利伐沙班治疗,观察组患者给予丹红注射液联合利伐沙班治疗;两组患者均连续治疗3～6个月。比较两组患者临床疗效,治疗前后呼吸频率、心率、动脉血氧分压(PaO2)、凝血功能指标[包括凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)及纤维蛋白原(FIB)、D-二聚体、蛋白C(PC)、蛋白S(PS)、组织型纤溶酶原激活物(t-PA)水平]、血管内皮功能指标[包括血清可溶性细胞间黏附分子1(sICAM-1)、内皮素1(ET-1)、血栓素B2(TXB2)、6-醛前列环素F1a(6-k-pGF1a)、一氧化氮(NO)水平]、炎性因子[包括血清C反应蛋白(CRP)、白介素10(IL-10)及肿瘤坏死因子α(TNF-α)水平],并观察两组患者治疗期间不良反应发生情况。结果 (1)两组患者临床疗效比较,差异无统计学意义(P>0.05)。(2)治疗前两组患者呼吸频率、心率及PaO2比较,差异无统计学意义(P>0.05);治疗后观察组患者呼吸频率、心率低于对照组,PaO2高于对照组(P<0.05)。(3)治疗前两组患者PT、APTT及FIB、D-二聚体、PC、PS、t-PA水平比较,差异无统计学意义(P>0.05);治疗后观察组患者PT、APTT长于对照组,FIB水平高于对照组,D-二聚体、PC、PS及t-PA水平低于对照组(P<0.05)。(4)治疗前两组患者血清sICAM-1、ET-1、TXB2、6-k-pGF1a、NO水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血清s ICAM-1、ET-1、TXB2水平低于对照组,血清6-k-pGF1a、NO水平高于对照组(P<0.05)。(5)治疗前两组患者血清CRP、IL-10、TNF-α水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血清CRP、IL-10、TNF-α水平低于对照组(P<0.05)。(6)观�Objective To study the clinical efficacy of Danhong injection combined with rivaroxaban in the treatment of acute pulmonary embolism(APE),and to analyze its effect on blood clotting function,vascular endothelial function and inflammatory reaction. Methods Eighty patients with APE who were admitted to Chang'an Hospital from March 2014 to April 2018 were selected,and they were divided into control group and observation group according to random number table method, each with 40 cases. Based on conventional treatment,patients in control group were treated with rivaroxaban alone,while patients in observation group were treated with Danhong injection combined with rivaroxaban;both groups continuously treated for 3 to 6 months. Clinical efficacy,respiratory rate,heart rate and PaO2,blood clotting function indicators〔including PT, APTT,FIB,D-dimer,protein C(PC),protein S(PS)and t-PA〕,vascular endothelial function indicators(including serum levels of sICAM-1,ET-1,TXB2,6-k-pGF1a and NO)and inflammatory cytokines(including serum levels of CRP, IL-10 and TNF-α)before and after treatment were compared between the two groups,and incidence of adverse reactions was observed during treatment. Results (1)There was no statistically significant difference in clinical efficacy between the two groups.(2)There was no statistically significant difference in respiratory rate,heart rate or PaO2 between the two groups before treatment(P>0.05);after treatment,respiratory rate and heart rate in observation group were statistically significantly lower than those in control group,while PaO2 in observation group was statistically significantly higher than that in control group (P<0.05).(3)There was no statistically significant difference in PT,APTT,FIB,D-dimer,PC,PS or t-PA between the two groups before treatment(P>0.05);after treatment,PT and APTT in observation group were statistically significantly longer than those in control group,FIB in observation group was statistically significantly higher than that in control group, D-dimer,PC,P

关 键 词：肺栓塞 丹红注射液 利伐沙班 凝血功能 血管内皮功能 炎性反应 

分 类 号：R563.5[医药卫生—呼吸系统]