利伐沙班用于肺栓塞患者抗凝疗效及对血管内皮功能血液高凝状态的影响  

Anticoagulant efficacy of rivaroxaban in patients with pulmonary embolism and its effects on endothelial function and hypercoagulable state of blood vessels

作　　者：肖甜 吉珉 严群锋 Xiao Tian;Ji Min;Yan Qunfeng(Department of Respiratory Medicine,Ninghai County First Hospital,Ningbo,Zhejiang 315600,China)

机构地区：[1]宁海县第一医院呼吸内科,浙江宁波315600

出　　处：《中国药物与临床》2025年第4期251-255,共5页Chinese Remedies & Clinics

摘　　要：目的探究利伐沙班用于急性肺栓塞(PE)抗凝治疗中的治疗效果及对血清内皮素-1(ET-1)、一氧化氮(NO)水平及凝血功能的影响。方法收集2021年1月至2023年12月浙江省宁海县第一医院收治的92例急性PE患者为研究对象,按随机数字表以简单随机分组法分为对照组(低分子肝素钙联合华法林抗凝治疗)、试验组(低分子肝素钙联合利伐沙班进行抗凝治疗)各46例,比较2组临床疗效,观察治疗前后2组血清ET-1、NO、凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)、呼吸频率、心率变化,比较2组药物不良反应发生率。结果试验组治疗后总有效率91.3%,较对照组(71.7%)升高(P<0.05)。与同组治疗前比较,治疗后2组血清FIB、D-D、ET-1[(2.11±0.23)g/L、(0.84±0.28)mg/L、(0.91±0.17)pg/ml;(3.46±0.34)g/L、(1.05±0.32)mg/L、(1.42±0.14)pg/ml]水平降低,试验组低于对照组;治疗后PT、APTT较治疗前延长,且试验组长于对照组[(11.6±1.5)s和(9.3±1.0)s;(26.9±3.0)s和(20.3±2.6)s],治疗后NO较治疗前升高,且试验组高于对照组[(59.2±6.7)μmol/L;(37.4±3.0)μmol/L(P<0.05)];与同组治疗前比较,治疗后2组呼吸频率、心率[(17.4±1.8)次/min、(72±7)次/min;(20.3±2.1)次/min、(86±9)次/min]降低,试验组低于对照组(P<0.05)。试验组不良反应发生率较对照组低(P<0.05)。结论利伐沙班在急性PE抗凝治疗中可提高患者临床疗效、有效调节血管内皮功能和血液高凝状态,同时稳定患者生命体征,其是急性PE抗凝治疗中的一种有效选择。Objective To explore the clinical effects of rivaroxaban in anticoagulant therapy for acute pulmonary embolism(PE)and its influence on serum endothelin-1(ET-1)and nitric oxide(NO)levels as well as coagulation function.Methods A total of 92 patients with acute PE admitted to Ninghai County First Hospital between January 2021 and December 2023 were enrolled in this perspective study.They were divided into a control group(low molecular weight heparin calcium combined with warfarin anticoagulant therapy)and an experimental group(low molecular weight heparin calcium combined with rivaroxaban for anticoagulant therapy)using a table of random numbers,with 46 cases in each group.Clinical effects,serum ET-1,NO,prothrombin time(PT),activated partial thrombin time(APTT),fibrinogen(FIB),D-Dimer(D-D),respiratory rate,heart rate and incidences of adverse drug reactions were compared between the two groups.Results The total response rate in the experimental group was 91.3%,significantly higher than that in the control group(71.7%)(P<0.05).Compared with the same group before treatment,serum ET-1,FIB and D-D levels in the two groups were significantly reduced after treatment[(2.11±0.23)g/L,(0.84±0.28)mg/L and(0.91±0.17)pg/ml vs(3.46±0.34)g/L,(1.05±0.32)mg/L and(1.42±0.14)pg/ml],and the experimental group showed significantly lower levels than the control group.PT and APTT were significantly prolonged and the experimental group showed significantly longer than those in the control group[(11.6±1.5)s vs(9.3±1.0)s;(26.9±3.0)s vs(20.3±2.6)s].The NO level was significantly increased[(59.2±6.7)μmol/L vs(37.4±3.0)μmol/L],and the experimental group showed significantly higher levels than the control group(P<0.05).Compared with the same group before treatment,the respiratory rate and heart rate of the two groups were significantly reduced after treatment[(17.4±1.8)times/min and(72±7)times/min vs(20.3±2.1)times/min and(86±9)times/min],but these indicators in the experimental group were significantly lower than those in the

关 键 词：肺栓塞 利伐沙班 抗凝药 一氧化氮 

分 类 号：R563.5[医药卫生—呼吸系统]