基于D-D、MMP-1、IR水平分析急性中毒患者血液净化联合达比加群酯的效果及下肢DVT危险因素  

A Study of the Effect of Blood Purification Combined with Dabigatran Etexilate Based on Levels of D-D,MMP-1 and IR in Patients with Acute Poisoning and the Risk Factors of Lower Extremity DVT

作　　者：闫蕾[1] 杨莉[1] 韩金涛[1] 赵冉冉[1] 张永刚 张秀飞 YAN Lei;YANG Li;HAN Jintao;ZHAO Ranran;ZHANG Yonggang;ZHANG Xiufei(Handan First Hospital,Handan 056002,China)

机构地区：[1]邯郸市第一医院,河北邯郸056002

出　　处：《标记免疫分析与临床》2023年第3期438-444,535,共8页Labeled Immunoassays and Clinical Medicine

基　　金：河北省卫生健康委科研基金项目(编号:20160022)。

摘　　要：目的探究血液净化联合达比加群酯对急性中毒患者下肢深静脉血栓(DVT)的防治效果及对D-二聚体(D-D)、血清基质金属蛋白酶-1(MMP-1)、胰岛素抵抗(IR)水平的影响。方法选取本院急诊科在2020年2月至2021年8月期间诊治的160例急性中毒患者血清展开研究。160例患者按照数字表法随机分为两组,研究组、常规组均为80例患者。常规组使用血液净化治疗方案,研究组应用血液净化联合达比加群酯治疗方案,检测并对比两组患者的D-D、MMP-1、IR水平差异,记录对比两组患者的下肢DVT发生率并进一步分析影响因素。结果(1)K-S检验显示所有计量资料均呈正态分布(P>0.05),两组的D-D均呈降低趋势变化且研究组变化幅度更大(P<0.05)。(2)两组的MMP-1水平均呈降低趋势变化且研究组的变化幅度更大(P<0.05)。(3)两组的IR水平均呈降低趋势变化且研究组的变化幅度更大(P<0.05)。(4)相比于常规组,研究组的下肢DVT发生率明显降低(P<0.05)。年龄≥60岁、BMI≥24kg/m 2、中度以上中毒者、D-D≥0.5mg/L的下肢DVT发生率明显升高,是下肢DVT发生的危险因素(P<0.05)。结论血液净化治疗联合达比加群酯治疗可以改善急性中毒患者的D-D、MMP-1、IR水平,同时该方案具有一定的安全性。针对存在下肢DVT风险的急性中毒患者进行重点看护。Objective To explore the effect of blood purification combined with dabigatran etexilate on the prevention and treatment of deep vein thrombosis(DVT)of lower extremities in patients with acute poisoning and its effect on the levels of D-dimer(D-D),serum matrix metalloproteinase-1(MMP-1)and insulin resistance(IR).Methods Serum was collected from 160 patients with acute poisoning who were diagnosed and treated in the Emergency Department of our hospital from February,2020 to August,2021.160 patients were randomly divided into two groups according to the digital table method,with 80 patients in both the study group and the routine group.The conventional group was treated with blood purification,while the study group was treated with blood purification combined with dabigatran etexilate.The levels of D-D,MMP-1,and IR of the two groups were detected and compared,and the incidence of lower extremity DVT of the two groups was recorded and compared.The influencing factors were further analyzed.Results(1)K-S test showed that all measurement data were normal distribution(P>0.05),while D-D of the two groups showed a decreasing trend,and the change in the study group was greater than that in the control group(P<0.05).(2)The level of MMP-1 in the two groups showed a decreasing trend,and the change in the study group was greater than that in the control group(P<0.05).(3)IR levels of the two groups showed a decreasing trend,and the change in the study group was greater than that in the control group(P<0.05).(4)Age≥60 years,BMI≥24kg/m 2,moderate or above poisoning,D-D≥0.5mg/L and lower extremity DVT incidence were significantly increased,and all were risk factors for lower extremity DVT(P<0.05).Conclusion Blood purification therapy combined with dabigatran etexilate can improve the levels of D-D,MMP-1 and IR in patients with acute poisoning with certain safety.There should be a focus on nursing care for acute poisoning patients with the risk of lower extremity DVT.

关 键 词：血液净化 达比加群酯 急性中毒 下肢深静脉血栓 胰岛素抵抗 基质金属蛋白酶-1 

分 类 号：R457[医药卫生—治疗学]