阿哌沙班联合瑞替普酶对急性肺栓塞患者凝血功能与安全性影响  

EFFECT OF APIXABAN COMBINED WITH RETEPLASE ON COAGULATION FUNCTION AND SAFETY IN PATIENTS WITH ACUTE PULMONARY EMBOLISM

作　　者：于鸿敏[1] 乔华[1] 张向宁[1] 董绍臣[1] 卢文宣[1] 李洁[1] YU Hongmin;QIAO Hua;ZHANG Xiangning;DONG Shaochen;LU Wenxuan;LI Jie(The First Hospital of Qinhuangdao City,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市第一医院,066000

出　　处：《中国煤炭工业医学杂志》2021年第4期381-386,共6页Chinese Journal of Coal Industry Medicine

基　　金：河北省卫计委科研课题(编号:20191377);秦皇岛市科技计划项目(编号:201602A230)。

摘　　要：目的分析阿哌沙班联合瑞替普酶对急性肺栓塞患者凝血功能与安全性影响。方法选取2016年1月—2019年12月于该院治疗的急性肺栓塞患者96例,随机数字表法将患者分为对照组,采用瑞替普酶结合华法林治疗,观察组采用阿哌沙班联合瑞替普酶治疗;观察患者临床疗效、右心功能、血清凝血指标、血管内皮指标、炎性指标改变与不良反应状况。结果观察组有效率为89.58%,高于对照组的70.83%(P<0.05);治疗后观察组患者RVEDVⅠ、RVESVⅠ较治疗前、对照组降低(均P<0.05);治疗后观察组患者血清D-D、PC、PS、TM、PAI-1及t-PA含量较治疗前、对照组降低,差异均有统计学意义(均P<0.05);治疗前后患者AT-Ⅲ含量变化差异无统计学意义(P>0.05);治疗后观察组血清CRP、IL-10、TNF-α含量较治疗前、对照组均降低,血清IL-38含量较治疗前、对照组升高(均P<0.05);观察组不良反应发生率为22.925%,低于对照组的41.67%,差异均有统计学意义(均P<0.05)。结论阿哌沙班联合瑞替普酶对急性肺栓塞患者疗效与凝血功能改善较为理想,患者出血率低于华法林。Objective To analyze the effects of apixaban combined with reteplase on coagulation function and safety in patients with acute pulmonary embolism.Methods Ninety six patients with acute pulmonary embolism treated in our hospital from January 2016 to December 2019 were selected and randomly divided into the control group treated with reteplase combined with warfarin,and the observation group treated with apixabancombined with reteplase;the clinical efficacy,right ventricular function,serum coagulation index,vascular endothelial index,inflammatory index and adverse reactions were observed.Results The effective rate in the observation group was 89.58%,which was higher than 70.83%in the control group(P<0.05).The RVEDVⅠand RVESVⅠin the observation group were lower than those in the control group and the control group after treatment(P<0.05).After treatment,the levels of serum D-D,PC,PS,TM,PAI-1 and t-PA in the observation group were lower than those before treatment and in the control group,and the differences were statistically significant(P<0.05);There was no statistically significant difference in the changes of AT-Ⅲcontent in patients before and after treatment(P>0.05);serum CRP and IL in the observation group after treatment-10.The content of TNF-αwas lower than that before treatment and the control group.The serum IL-38 content was higher than that before treatment and the control group(P<0.05).The incidence of adverse reactions in the observation group was 22.925,which was lower than 41.67%in the control group,and the differences were statistically significant(P<0.05).Conclusion Apixaban combined with reteplase is more effective in improving the coagulation function in patients with acute pulmonary embolism,and the bleeding rate is lower than warfarin.

关 键 词：急性肺栓塞 瑞替普酶 阿哌沙班 白细胞介素-38 凝血功能 

分 类 号：R563[医药卫生—呼吸系统]