利伐沙班对脑梗死患者Xa因子及炎性因子的影响  

Effects of rivaroxaban on factor Xa and inflammatory factors in patients with cerebral infarction

作　　者：洪雁[1] 高蕊 何云燕[1] HONG Yan;GAO Rui;HE Yun-yan(Department of Fifth Ward of Neurology,Tianjin Huanhu Hospital,Tianjin 300060,China)

机构地区：[1]天津市环湖医院神经内科五病区,天津300060

出　　处：《中国城乡企业卫生》2021年第12期10-13,共4页Chinese Journal of Urban and Rural Enterprise Hygiene

基　　金：天津市卫生行业重点攻关项目(16KG160)。

摘　　要：目的探讨新型口服抗凝药利伐沙班对非瓣膜性房颤脑梗死患者Xa因子活性及血清炎性因子水平的影响。方法本研究选取2017年10月—2019年10月天津市环湖医院收治的非瓣膜性房颤脑梗死患者100例,随机分为对照组和研究组各50例。在常规治疗基础上,对照组给予华法林抗凝治疗,研究组给予利伐沙班抗凝治疗,两组均随访1年。于随访3个月和1年时检测凝血功能、Xa因子活性、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平。结果治疗后3个月、1年,研究组APTT、PT和INR均低于对照组,差异均有统计学意义(P<0.05)。治疗后3个月、1年,利伐沙班服药2 h后Xa因子活性分别为(467.34±146.22)和(439.50±120.48)pg/ml,明显低于服药前的(897.23±154.40)和(845.87±136.29)pg/ml,差异均有统计学意义(P<0.05)。治疗后3个月、1年,两组血清TNF-α、IL-6浓度均明显低于治疗前,且研究组TNF-α、IL-6浓度明显低于对照组,差异均有统计学意义(P<0.05)。结论 Xa因子活性可以用来监测利伐沙班的抗凝作用,预测非瓣膜性房颤患者卒中复发的风险。抗凝药物可能通过抗炎途径加强了心肌和脑保护作用,关注非瓣膜性房颤患者炎性因子的浓度变化,选择联合相关抗炎治疗,对预防和治疗非瓣膜性房颤脑梗死有重要意义。Objective To investigate the effect of rivaroxaban,a new oral anticoagulant,on factor Xa activity and serum inflammatory factor level in patients with non valvular atrial fibrillation cerebral infarction. Methods In this study,100 patients with non valvular atrial fibrillation cerebral infarction treated in Tianjin Huanhu Hospital from October 2017 to October 2019 were selected and randomly divided into control group and study group with 50 cases in each group. On the basis of routine treatment,the control group was given warfarin anticoagulant treatment,and the study group was given rivaroxaban anticoagulant treatment. Both groups were followed up for 1 year. The coagulation function,factor Xa activity,the levels of interleukin-6(IL-6)and tumor necrosis factor-α (TNF-α)were measured after treatment 3 months and 1 year. Results Three months and one year after treatment,APTT,PT and INR in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05). Three months and one year after treatment,the activity of factor Xa after rivaroxaban treatment for 2 hours were(467.34 ±146.22)and(439.50±120.48)pg/ml,respectivey,which were significantly lower than(897.23±154.40)and(845.87 ±136.29) pg/ml measured before treatment,and the differences were statistically significant(P<0.05). Three months and one year after treatment,the concentrations of serum TNF-α and IL-6 in the two groups were significantly lower than those before treatment,the concentration of serum TNF-α and IL-6 in the study group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05). Conclusion Factor Xa activity could be used to monitor the anticoagulant effect of rivaroxaban and predict the risk of stroke recurrence in patients with non valvular atrial fibrillation.Anticoagulant drugs might strengthen the myocardial and brain protection through anti-inflammatory approach. Paying attention to the concentration changes of inflammatory fa

关 键 词：非瓣膜性房颤 利伐沙班 华法林 XA因子 炎性因子 

分 类 号：R741.05[医药卫生—神经病学与精神病学]