利伐沙班联合低分子量肝素钙治疗急性肺栓塞的疗效及对肺通气功能和血浆抗Xa活性水平的影响  

Efficacy of Rivaroxaban Combined with Low Molecular Weight Heparin Calcium in the Treatment of Acute Pulmonary Embolism and Its Effect on Pulmonary Ventilation Function and Plasma Anti-Xa Activity

作　　者：王慧 杨燕 崔敏 WANG Hui;YANG Yan;CUI Min(Department of Pulmonary,Jinan Hospital of Integrated Traditional Chinese and Western Medicine,Jinan,Shandong Province,271100 China;Department of Cardiology,Jinan Hospital of Integrated Traditional Chinese and Western Medicine,Jinan,Shandong Province,271100 China;Department of Injection Room,Jinan Hospital of Integrated Traditional Chinese and Western Medicine,Jinan,Shandong Province,271100 China)

机构地区：[1]济南市中西医结合医院肺病科,山东济南271100 [2]济南市中西医结合医院心病科,山东济南271100 [3]济南市中西医结合医院注射室,山东济南271100

出　　处：《中外医疗》2024年第13期13-17,共5页China & Foreign Medical Treatment

摘　　要：目的探讨利伐沙班与低分子量肝素钙联合治疗急性肺栓塞(Acute Pulmonary Embolism,APE)的效果。方法方便选取2020年6月—2023年7月济南市中西医结合医院收治的122例APE患者为研究对象,采用随机数表法分为两组,各61例。对照组皮下注射低分子量肝素钙注射液结合口服华法林钠片,观察组皮下注射低分子量肝素钙注射液结合口服利伐沙班片。比较两组临床疗效、肺通气功能、血浆抗Xa活性水平、不良反应。结果观察组总有效率为93.44%,显著高于对照组的78.69%,差异有统计学意义(χ^(2)=5.536,P<0.05)。治疗后,观察组每分通气量、血氧饱和度、潮气量均高于对照组,呼气末二氧化碳分压、血浆抗Xa活性水平均低于对照组,差异有统计学意义(P均<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论利伐沙班与联合分子量肝素钙具有较好的效果,能够显著改善肺通气功能,促使血清Xa水平进一步降低,且用药安全性较高。Objective To investigate the specific effects of rivaroxaban combined with low molecular weight heparin calcium in the treatment of acute pulmonary embolism(APE).Methods A total of 122 patients with APE admitted to Jinan Hospital of Integrated Chinese and Western Medicine from June 2020 to July 2023 were conveniently selected as the study objects and were divided into two groups with 61 patients in each group by random number table method.The control group was subcutaneously injected with low molecular weight heparin calcium injection combined with oral warfarin sodium tablets,and the observation group was subcutaneously injected with low molecular weight heparin calcium injection combined with oral rivaroxaban tablets.The clinical efficacy,pulmonary ventilation function,plasma anti-XA activity level and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 93.44%,which was significantly higher than that of the control group(78.69%),the difference was statistically significant(χ^(2)=5.536,P<0.05).After treatment,each minute ventilation volume,blood oxygen saturation and tidal volume in observation group were higher than those in control group,while the end expiratory partial pressure of carbon dioxide and plasma anti-Xa activity levels were lower than those in control group,the differences were statistically significant(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Rivaroxaban and combined molecular weight heparin calcium have a good effect,can significantly improve lung ventilation function,promote the level of serum Xa further decreased,and the drug safety is higher.

关 键 词：急性肺栓塞 利伐沙班 低分子量肝素钙 肺通气功能 血浆抗Xa活性 

分 类 号：R563[医药卫生—呼吸系统]