低剂量利伐沙班与低分子量肝素钙在急性肺栓塞患者中的应用比较  

Comparison of Low-Dose Rivaroxaban and Low Molecular Weight Heparin Calcium in Patients with Acute Pulmonary Embolism

作　　者：尚宜星 卢克鹏 肖淑娜 SHANG Yi-xing;LU Ke-peng;XIAO Shu-na(Department of Pharmacy,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院药学部,洛阳471000

出　　处：《中国合理用药探索》2024年第4期83-88,共6页Chinese Journal of Rational Drug Use

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200577)。

摘　　要：目的:探讨低剂量利伐沙班与低分子量肝素钙治疗急性肺栓塞患者的疗效差异。方法:选取2021年2月~2022年2月期间于某院诊治的120例急性肺栓塞患者作为研究对象,根据随机数字表法分为低剂量利伐沙班组(A组)与低分子量肝素钙组(B组),每组60例。所有患者入院后均给予常规对症治疗,A组在常规对症治疗基础上口服利伐沙班片,B组在常规对症治疗基础上皮下注射低分子量肝素钙注射液,两组均连续治疗3个月。比较两组患者临床疗效、凝血功能指标[活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)和凝血酶原时间(PT)]、肺功能指标[用力肺活量占预计值百分比(FVC%pred)、第1秒用力呼气容积(FEV1)及FEV1占预计值百分比(FEV1%pred)]、动脉血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]及不良反应发生情况。结果:治疗后,A组患者治疗总有效率(86.67%)高于B组(70.00%,P<0.05);两组患者APTT、PT均升高(P<0.05),且A组高于B组(P<0.05);两组患者FIB均降低(P<0.05),且A组低于B组(P<0.05);两组患者FVC%pred、FEV1、FEV1%pred均升高(P<0.05),且A组高于B组(P<0.05);两组患者PaO_(2)、PaCO_(2)均改善(P<0.05),且A组改善更显著(P<0.05);A组患者治疗期间不良反应总发生率(6.67%)低于B组(26.67%,P<0.05)。结论:低剂量利伐沙班与低分子量肝素钙均可有效改善急性肺栓塞患者的凝血功能、肺功能,且低剂量利伐沙班的临床疗效较低分子量肝素钙更佳,患者不良反应发生率更低。Objective:To explore difference in efficacy between low-dose rivaroxaban and low molecular weight heparin calcium in the treatment of patients with acute pulmonary embolism.Methods:A total of 120 patients with acute pulmonary embolism treated in a hospital from February in 2021 to February in 2022 were selected.According to the random number table method,they were divided into low-dose rivaroxaban group(group A)and low molecular weight heparin calcium group(group B),with 60 cases in each group.After admission,all patients were administrated conventional symptomatic treatment.Group A was administrated oral rivaroxaban tablets on the basis of conventional symptomatic treatment,group B was administrated subcutaneous injection of low molecular weight heparin calcium injection on the basis of conventional symptomatic treatment,and both groups were treated continuously for 3 months.The clinical efficacy,coagulation function indexes[activated partial thromboplastin time(APTT),fibrinogen(FIB)and prothrombin time(PT)],lung function indexes[forced vital capacity as a percentage of the predicted value(FVC%pred),forced expiratory volume in one second(FEV1)and its percentage of the predicted value(FEV1%pred)],arterial blood gas analysis indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))]and adverse reactions were compared between the two groups.Results:After treatment,the total effective rate of group A(86.67%)was higher than that of group B(70.00%,P<0.05).The levels of APTT and PT were elevated in both groups(P<0.05),and those in group A were higher than those in group B(P<0.05).The level of FIB was decreased in both groups(P<0.05),and that in group A was lower than that in group B(P<0.05).The FVC%pred,FEV1 and FEV1%pred were increased in both groups(P<0.05),and those in group A were higher than those in group B(P<0.05).PaO_(2)and PaCO_(2)were improved in both groups(P<0.05),with more significant improvement in group A(P<0.05).The overall incidence of adverse reactions

关 键 词：急性肺栓塞 利伐沙班 低分子量肝素钙 低剂量 凝血功能 肺功能 动脉血气分析 

分 类 号：R563.5[医药卫生—呼吸系统]