利伐沙班对抗凝血酶Ⅲ降低的下肢深静脉血栓患者的治疗效果  

Efficacy of rivaroxaban in the treatment of lower extremity deep vein thrombosis with reduced antithrombinⅢ

作　　者：曹彭凯 朱恬仪 高瑞姣 李亮[1] 罗欣彤 仝彤[4] 张彦荣[1] 刘向东[1] 李云松[1] Cao Pengkai;Zhu Tianyi;Gao Ruijiao;Li Liang;Luo Xintong;Tong Tong;Zhang Yanrong;Liu Xiangdong;Li Yunsong(Department of Vascular Surgery,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,Hebei,China;Department of Clinical laboratory,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,Hebei,China;Department of Neurology,Hebei General Hospital,Shijiazhuang 050057,Hebei,China;Department of Anesthesiology,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050017,Hebei,China)

机构地区：[1]河北医科大学第三医院血管外科,河北石家庄050051 [2]河北医科大学第三医院检验科,河北石家庄050051 [3]河北省人民医院神经内科,河北石家庄050057 [4]河北医科大学第四医院麻醉科,河北石家庄050017

出　　处：《血管与腔内血管外科杂志》2024年第7期787-791,共5页Journal of Vascular and Endovascular Surgery

基　　金：河北省医学科学研究课题计划(20200982)。

摘　　要：目的探讨利伐沙班治疗抗凝血酶Ⅲ降低的下肢深静脉血栓(DVT)患者的有效性和安全性。方法收集2019年1月至2022年12月于河北医科大学第三医院就诊的78例抗凝血酶Ⅲ降低的下肢DVT患者的临床资料,根据治疗方法的不同将其分为利伐沙班组(n=35,采用利伐沙班抗凝治疗)与低分子肝素组(n=43,入院后首先采用低分子肝素抗凝治疗1周后改为利伐沙班抗凝治疗),比较两组患者下肢DVT进展情况。结果低分子肝素组患者入院后首先采用低分子肝素治疗期间血栓进展率为32.56%(14/43),高于利伐沙班组患者的8.57%(3/35),差异有统计学意义(P﹤0.05)。入院后1周,低分子肝素组患者全部换用利伐沙班继续抗凝治疗后血栓进展率为9.30%(4/43),与利伐沙班组患者的8.57%(3/35)比较,差异无统计学意义(P﹥0.05)。两组患者均未发生严重出血事件,住院期间无症状性肺栓塞发生。结论利伐沙班对抗凝血酶Ⅲ降低的下肢DVT患者抗凝治疗具有较好的有效性和安全性。Objective To investigate the efficacy and safety of rivaroxaban in the treatment of lower extremity deep vein thrombosis(DVT)with antithrombinⅢreduction.Method Clinical data of 78 lower extremity DVT patients with decreased antithrombinⅢwere collected from the Third Hospital of Hebei Medical University from January 2019 to December 2022.According to different treatment methods,they were divided into rivaroxaban group(n=35,given rivaroxaban anticoagulant therapy)and low molecular weight heparin group(n=43,after admission,low molecular weight heparin anticoagulant therapy was first used,1 week later the rivaroxaban anticoagulant therapy was changed).The progression of lower extremity DVT was compared between the two groups.Result The rate of thrombosis progression was 32.56%(14/43)in low molecular weight heparin group,higher than 8.57%(3/35)in rivaroxaban group,the difference was statistically significant(P<0.05).One week after admission,the rate of thrombosis progression in the low molecular weight heparin group was 9.30%(4/43)after continued anticoagulation therapy with rivaroxaban,which was not statistically significant compared with 8.57%(3/35)in the rivaroxaban group(P>0.05).No serious bleeding events occurred in both groups,and no symptomatic pulmonary embolism occurred during hospitalization.Conclusion Rivaroxaban has good efficacy and safety in the anticoagulant treatment of lower extremity DVT patients with reduced antithrombinⅢ.

关 键 词：下肢深静脉血栓 抗凝血酶Ⅲ 利伐沙班 低分子肝素 抗凝治疗 

分 类 号：R543[医药卫生—心血管疾病]