利伐沙班治疗头颈部静脉血栓栓塞的疗效与安全性研究  

Efficacy and safety study of rivaroxaban for head and neck venous thromboembolism patients

作　　者：傅琳琳 李嘉琪[3] 王宝彦 李俐 FU Linlin;LI Jiaqi;WANG Baoyan;LI Li(Department of Pharmacy,China Pharmaceutical University,Nanjing Drum Tower Hospital,Jiangsu Nanjing 210008,China;School of Basic Medicine&Clinical Pharmacy,China Pharmaceutical University,Jiangsu Nanjing 210008,China;Department of Pharmacy,Nanjing Drum Tower Hospital,Affiliated Hospital,School of Medicine,Nanjing University,Jiangsu Nanjing 210008,China)

机构地区：[1]中国药科大学/南京鼓楼医院药学部,江苏南京210008 [2]中国药科大学基础医学与临床药学学院,江苏南京210008 [3]南京大学医学院附属鼓楼医院药学部,江苏南京210008

出　　处：《中国医院药学杂志》2024年第23期2751-2754,共4页Chinese Journal of Hospital Pharmacy

基　　金：南京大学医学院附属南京鼓楼医院临床试验项目(编号:2021-LCYJ-PY-19)。

摘　　要：目的:探讨利伐沙班在头颈部静脉血栓栓塞(venous thromboembolism,VTE)抗凝治疗中的疗效与安全性。方法:回顾性队列研究纳入了2015年12月至2022年1月期间在南京鼓楼医院就诊的头颈部VTE患者,根据患者服用的抗凝药物将其分为华法林组和利伐沙班组,所有患者均进行至少2年的随访观察,收集两组患者的基线资料、血栓复发及出血事件,并采用逆概率加权法平衡两组基线资料的差异,通过Kaplan-Meier曲线及多因素COX比例风险模型比较两组患者发生血栓复发及出血事件的差异。结果:共纳入291例患者,经过逆概率加权后,两组患者的基线资料差异无统计学意义,华法林组和利伐沙班组在血栓复发、所有出血事件及大出血事件方面的发生率差异均无统计学意义(HR=0.64,95%CI:0.30~1.31;HR=0.47,95%CI:0.20~1.11;HR=0.65,95%CI:0.23~1.85),肾功能亚组与治疗组在所有出血事件及大出血事件方面存在明显交互作用(P=0.012;P=0.048)。结论:在头颈部VTE的抗凝治疗中利伐沙班的疗效和安全性与华法林相似。OBJECTIVE To explore the clinical efficacy and safety of rivaroxaban for head and neck venous thromboembolism(VTE).METHODS From December 2015 to January 2022,for this retrospective cohort study,291 patients with head and neck VTE were recruited at Nanjing Drum Tower Hospital.Based upon specific anticoagulants,they were assigned into two groups of warfarin and rivaroxaban.Follow-up period was at least 2 years.Baseline profiles,recurrent VTE and bleeding events were recorded for two groups.Inverse probability of treatment weighting(IPTW)was employed for balancing the inter-group differences in baseline profiles.Kaplan-Meier curve and multivariate COX proportional hazard model were utilized for comparing the inter-group differences in recurrent VTE and bleeding events.RESULTS After stable IPTW,there was no significant intergroup difference in baseline profiles.And no statistically significant inter-group difference existed in rates of recurrent VTE,all bleeding events and major bleeding events(HR=0.64,95%CI:0.30-1.31;HR=0.47,95%CI:0.20-1.11;HR=0.65,95%CI:0.23-1.85).Renal function hinted at significant interaction with treatment group in terms of all bleeding events and major bleeding events(P=0.012;P=0.048).CONCLUSION Rivaroxaban has similar anticoagulation efficacy and safety to warfarin in patients with head and neck VTE.

关 键 词：头颈部静脉血栓栓塞 华法林 利伐沙班 疗效 安全性 

分 类 号：R973[医药卫生—药品]