肺癌患者急性非大面积肺栓塞的影响因素及低分子量肝素联合利伐沙班治疗的临床疗效  

Factors affecting acute non-massive pulmonary embolism in patients with lung cancer and clinical efficacy of low molecular weight heparin combined with rivaroxaban therapy

作　　者：王桃桃 翟奇辉 鲁张波 庞建芳 WANG Taotao;ZHAI Qihui;LU Zhangbo;PANG Jianfang(Department of Respiratory Medicine,Linfen People’s Hospital,Linfen 041081,China)

机构地区：[1]临汾市人民医院呼吸内科,山西临汾041081

出　　处：《陕西医学杂志》2025年第4期519-523,共5页Shaanxi Medical Journal

基　　金：山西省卫生健康委员会科研项目(2022XT661)。

摘　　要：目的:探究肺癌患者急性非大面积肺栓塞的影响因素及低分子量肝素联合利伐沙班治疗的临床疗效。方法:选取收治的肺癌患者108例展开研究,按患者是否急性非大面积肺栓塞分为对照组与治疗组,各54例,对照组在常规治疗上采用低分子量肝素联合华法林治疗,治疗组采用低分子量肝素联合利伐沙班治疗;二元Logistic回归分析肺癌患者急性非大面积肺栓塞的影响因素;比较两组临床疗效、肺通气功能、血气及凝血功能及不良反应差异。结果:以肺癌患者是否出现急性非大面积肺栓塞为因变量,将单因素分析中有统计学意义的纤维蛋白原水平(FIB)、吸烟史、血红蛋白、红细胞比容、D-二聚体水平(D-D)、血氧分压水平(PaO_(2))、TNM分期为自变量,纳入二元Logistic回归模型,FIB、吸烟史、血红蛋白、D-D、TNM分期均为肺癌患者急性非大面积肺栓塞的影响因素(均P<0.05)。治疗组患者的临床疗效高于对照组。两组治疗后肺通气功能、PT、PO_(2)、PCO_(2)及活化部分凝血活酶时间(APTT)比较差异有统计学意义(均P<0.05)。治疗组不良反应低于对照组,差异无统计学意义(P>0.05)。结论:吸烟、血红蛋白升高及TNM分期高是肺癌患者急性非大面积肺栓塞的影响因素。而联合用药通过抗凝、抗炎等机制显著改善患者肺通气、血气及凝血功能及降低不良反应,为肺癌合并肺栓塞患者提供有效且安全的治疗方案。Objective:To investigate the influencing factors of acute non-massive pulmonary embolism in lung cancer patients and the clinical efficacy of low molecular weight heparin combined with rivaroxaban treatment.Methods:A study was conducted on 108 lung cancer patients who were admitted to the hospital.They were divided into a control group and a treatment group,with 54 patients in each,based on whether they had acute non-massive pulmonary embolism.The control group received conventional treatment combined with low-molecular-weight heparin and warfarin,while the treatment group received low-molecular-weight heparin combined with rivaroxaban.Binary logistic regression analysis was performed to identify the factors influencing acute non-massive pulmonary embolism in lung cancer patients.The clinical efficacy,pulmonary ventilation function,blood gas and coagulation function,as well as differences in adverse reactions,were compared between the two groups.Results:Using the occurrence of acute non-massive pulmonary embolism in lung cancer patients as the dependent variable,and including fibrinogen level(FIB),smoking history,hemoglobin,hematocrit,D-dimer level(D-D),partial pressure of oxygen(PaO_(2)),and TNM stage as independent variables that were statistically significant in the univariate analysis,we incorporated these into a binary logistic regression model.FIB,smoking history,hemoglobin,D-D,and TNM stage were all found to be influencing factors for acute non-massive pulmonary embolism in lung cancer patients(all P<0.05).The clinical efficacy in the treatment group was higher than that in the control group.There were statistically significant differences between the two groups in pulmonary ventilation function,prothrombin time(PT),partial pressure of oxygen(PO_(2)),partial pressure of carbon dioxide(PCO_(2)),and activated partial thromboplastin time(APTT)after treatment(all P<0.05).The incidence of adverse reactions in the treatment group was lower than that in the control group,although the difference was not statistica

关 键 词：肺癌 急性非大面积肺栓塞 影响因素 低分子量肝素 利伐沙班 临床疗效 

分 类 号：R734.2[医药卫生—肿瘤]