利伐沙班、脉血康联合腔内介入治疗髂股静脉血栓形成后综合征疗效及对凝血-纤溶功能和血管内皮功能的影响  

Efficacy of rivaroxaban and Maixuekang combined with endovascular intervention on iliofemoral venous post-thrombotic syndrome and its effect on coagulation-fibrinolysis and vascular endothelial function

作　　者：范惠双[1] 谭志斌[1] 曾汉强 莫灿均 刘欢 肖亦明[1] FAN Huishuang;TAN Zhibin;ZENG Hanqiang;MO Canjun;LIU Huan;XIAO Yiming(Dongguan People’s Hospital, Dongguan 523059, Guangdong, China)

机构地区：[1]广东省东莞市人民医院,广东东莞523059

出　　处：《现代中西医结合杂志》2020年第10期1063-1066,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：东莞市社会科技发展项目(东科[2015]202号2015108101026)。

摘　　要：目的观察利伐沙班、脉血康联合腔内介入治疗髂股静脉血栓形成后综合征(PTS)患者的疗效及对凝血-纤溶功能和血管内皮功能的影响。方法将2014年1月—2016年12月在东莞市人民医院确诊的132例单侧髂股静脉PTS患者随机分为2组,每组66例。2组均采用介入治疗,术后对照组给予利伐沙班口服,观察组给予利伐沙班联合脉血康口服,疗程为3个月。计算2组患肢膝关节下15 cm处小腿周径在治疗1个月、2个月、3个月后与治疗前的差值,比较2组治疗前和治疗1个月、2个月和3个月后Villalta评分量表评分,检测2组治疗前及治疗1个月后凝血-纤溶指标[凝血酶原时间(TT)、部分凝血酶原时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)]和血管内皮功能指标[血清一氧化氮(NO)、内皮素-1(ET-1)、6-酮-前列腺素F1α(6-Keto-PGF1α)、血栓素B2(TXB2)]水平。结果观察组治疗1个月、2个月和3个月后小腿周径与治疗前的差值与对照组相比明显升高(P均<0.05);2组治疗1个月、2个月、3个月后Villalta评分均明显降低(P均<0.05),且观察组明显低于对照组(P均<0.05)。2组治疗1个月后APTT、PT和TT均明显延长(P均<0.05),FIB、D-D、ET-1和TXB2水平均明显降低(P均<0.05),NO和6-Keto-PGF1α水平均明显升高(P均<0.05),且观察组改善更明显(P均<0.05)。结论利伐沙班、脉血康联合腔内介入治疗髂股静脉PTS患者效果更好,可能与明显改善机体的凝血-纤维功能和血管内皮功能有关。Objective It is to observe the efficacy of rivaroxaban and Maixuekang combined with endovascular intervention on iliofemoral venous post-thrombotic syndrome(PTS)and its effect on coagulation-fibrinolysis and vascular endothelial function.Methods A total of 132 patients with iliofemoral venous PTS diagnosed in Dongguan People’s Hospital from January 2014 to December 2016 were randomly divided into two groups,66 cases in each group.Both groups were treated with interventional therapy.The control group was given oral rivaroxaban after operation,and the observation group was given oral rivaroxaban combined with Maixuekang,both groups were treated for 3 months.The difference in calf circumference at 15 cm below the knee joint after 1 month,2 months,3 months of treatment and before treatment were calculated in the two groups.The scores of Villalta score scale before treatment,and after 1 month,2 months,3 months of treatment were compared between the two groups,the coagulation-fibrinolysis indicators[thrombin time(TT),partial thrombin time(APTT),fibrinogen(FIB),D-dimer(DD)]and vascular endothelial function indicators[serum nitric oxide(NO),endothelin-1(ET-1),6-keto-prostaglandin F1α(6-Keto-PGF1α),thromboxane B2(TXB2)]before and after one months of treatment were detected in the two groups.Results The differences in the calf circumference before treatment and after 1 month,2 months,and 3 months of treatment in the observation group were significantly higher than those in the control group(P<0.05).The Villalta scores were significantly reduced after 1 months,2 months and 3 months of treatment in the two groups(P<0.05),and the observation group was significantly lower than the control group(P<0.05).After 1 month of treatment APTT,PT and TT were significantly prolonged(P<0.05),the levels of FIB,DD,ET-1 and TXB2 were significantly reduced(P<0.05),and the levels of NO and 6-Keto-PGF1αwere significantly increased in the two groups(P<0.05),and the improvement in the observation group was more significant(P<0.05).Conclusion

关 键 词：静脉血栓后综合征 腔内介入治疗 脉血康 利伐沙班 凝血-纤溶 血管内皮功能 

分 类 号：R654.3[医药卫生—外科学]