基于倾向评分匹配的利伐沙班与低分子肝素一级预防住院癌症患者VTE形成的有效性及安全性对比研究  

A Comparative Study on the Efficacy and Safety of Rivaroxaban Versus Low-molecular-weight Heparin in the Primary Prevention of Venous Thromboembolism in Hospitalized Cancer Patients Based on Propensity Score Matching

作　　者：陶晶晶[1] 方芸 TAO Jingjing;FANG Yun(Department of Pharmacy,Nanjing BenQ Medical Center,the Affiliated BenQ Hospital of Nanjing Medical University,Nanjing 210019,China)

机构地区：[1]南京医科大学附属明基医院药学部,南京210019

出　　处：《药学与临床研究》2025年第1期14-17,共4页Pharmaceutical and Clinical Research

基　　金：2023年南京药学会医院药学科研基金一般项目(2023YX009);2024年南京药学会医院药学科研基金一般项目(2024YX023)。

摘　　要：目的:比较利伐沙班与低分子肝素(LMWH)一级预防住院癌症患者VTE形成的有效性与安全性。方法:通过医院信息系统筛选2019年1月1日-2023年6月30日使用利伐沙班或LMWH的患者。采用倾向评分匹配(PSM)1∶1的比例匹配利伐沙班组与LMWH组病例数。主要终点为住院期间VTE发生率,次要终点为住院期间出血、全因死亡率以及随访6个月的VTE、出血及全因死亡率。采用条件logistics回归分析两组抗凝方案对各终点的效应。结果:筛选出728例住院癌症患者,PSM后利伐沙班组与LMWH组各288例。两组不同抗凝方案对住院期间VTE、出血及随访6个月的VTE、出血及全因死亡率的差异均无统计学意义(P>0.05),但利伐沙班组住院期间全因死亡率为LMWH组的40%(OR=0.4,95%CI:0.17~0.94,P=0.036)。结论:利伐沙班可能是代替LMWH用于住院癌症患者VTE一级预防的另一个选择。Objective:To compare the efficacy and safety of rivaroxaban and low-molecular-weight heparin(LMWH)in hospitalized cancer patients to provide evidence for the use of anticoagulants in pre-venting venous thromboembolism(VTE).Methods:Patient data were collected through patient medical records.Propensity score matching(PSM)was used to match the number of cases in the rivaroxaban group and the LMWH group at a ratio of 1∶1.The primary endpoint was the incidence of VTE during hospitalization,and the secondary endpoints was the incidence of bleeding and all-cause mortality during hospitalization,and the incidence of VTE,bleeding and all-cause mortality at 6-month follow-up.Condi-tional logistics regression was used to analyze the effects of anticoagulation regimens on each endpoint.Results:Using the PSM method,this study include 288 patients in the rivaroxaban group and 288 in the LMWH group.The results showed that the two anticoagulation regimens had no different impact on the hospitalization incidence of VTE and bleeding,and the 6-month incidence of VTE,bleeding and all-cause mortality.However,the all-cause mortality rate during hospitalization was 60%lower in the rivaroxa-ban group than in the LMWH group(OR=0.4,95%CI:0.17-0.94,P=0.036).Conclusion:Rivaroxaban may be another option for VTE primary pretention in hospitalized cancer patients instead of LMWH.

关 键 词：倾向评分匹配 利伐沙班 低分子肝素 癌症患者 静脉血栓 一级预防 

分 类 号：R973.2[医药卫生—药品]