利伐沙班对急性肺栓塞患者血管内皮功能及凝血功能指标的影响  

Effect of Rivaroxaban on Vascular Endothelial Function and Coagulation Function Indicators in Patients with Acute Pulmonary Embolism

作　　者：王向迎 韩利娜[1] Wang Xiangying;Han Lina(Respiratory and Critical Care Medicine Department,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan,450052,China)

机构地区：[1]河南科技大学第一附属医院呼吸与危重症医学科,河南洛阳450052

出　　处：《黑龙江医学》2025年第7期783-785,789,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨急性肺栓塞(APE)患者应用利伐沙班联合低分子肝素钙的治疗效果。方法:选取2021年4月—2023年4月河南科技大学第一附属医院收治的80例APE患者作为研究对象,按随机数表法分为两组,对照组(40例)行华法林联合低分子肝素钙治疗,研究组(40例)行利伐沙班联合低分子肝素钙治疗。对比两组患者临床疗效、临床症状缓解时间、凝血功能指标、血清炎性因子水平、动脉血氧分压(PaO2)、血管内皮功能指标[内皮素1(ET-1)、一氧化氮(NO)、血栓素B2(TXB2)]和不良反应。结果:研究组临床疗效较对照组高,差异有统计学意义(χ^(2)=7.314,P<0.001);研究组胸痛、紫绀、呼吸困难缓解时间较对照组短,差异均有统计学意义(t=10.496、11.431、22.464,P<0.001);研究组治疗后凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)较对照组高,血清D-二聚体(D-D)、血清纤维蛋白原(FIB)水平较对照组低,差异均有统计学意义(t=6.439、5.162、4.634、6.833,P<0.001);研究组C反应蛋白(CRP)、白介素-10(IL-10)、肿瘤坏死因子α(TNF-α)水平较对照组低,PaO2较对照组高,差异有统计学意义(P<0.05);研究组治疗后ET-1、TXB2水平较对照组低,NO水平较对照组高,差异有统计学意义(P<0.05);研究组不良反应较对照组少,差异有统计学意义(χ^(2)=4.114,P=0.043)。结论:利伐沙班联合低分子肝素钙治疗APE在改善患者血管内皮功能及抗凝方面效果显著,可有效降低血清炎性因子水平,利于加速症状恢复。Objective:To explore the therapeutic effect of rivaroxaban combined with low molecular weight heparin calcium in patients with acute pulmonary embolism(APE).Methods:80 APE patients in the hospital from April 2021 to April 2023 were divided into two groups with a random number table method.The control group(40 cases)received treatment with warfarin and low molecular weight heparin calcium,while the study group(40 cases)received treatment with rivaroxaban and low molecular weight heparin calcium.The clinical efficacy,clinical symptom relief time,coagulation function indicators,serum inflammatory factor levels,arterial oxygen pressure(PaO2),vascular endothelial function indicators[endothelin-1(ET-1),nitric oxide(NO),thromboxane B2(TXB2)]and adverse reactions between two groups were compared.Results:The clinical effect of the study group was higher than that of the control group,and the difference was statistically significant(χ^(2)=7.314,P<0.05).The relief time of chest pain,cyanosis and dyspnea in the study group was shorter than that in the control group,and the differences were statistically significant(t=10.496,11.431,22.464;P<0.05).The prothrombin time(PT)and activated partial prothrombin time(APTT)of the study group after treatment were higher than those of the control group,and the levels of serum D-dimer(D-D)and serum fibrinogen(FIB)were lower than those of the control group,with statistically significant difference(t=6.439,5.162,4.634,6.833;P<0.05).CRP,IL-10,TNF-αof the study group were lower,and the PaO2 was higher than the control group(P<0.05).ET-landTXB2 of the study group were lower,and No was higher than the control group(P<0.05).The adverse reaction of the study group was less(χ^(2)=4.114,P=0.043).Conclusion:The combination of rivaroxaban and low molecular weight heparin calcium has significant effect on improving vascular endothelial function and anticoagulation in patients with APE.It can effectively reduce serum inflammatory factor levels,and accelerate symptom recovery.

关 键 词：急性肺栓塞 利伐沙班 低分子肝素钙 血管内皮功能 凝血功能指标 炎性因子 

分 类 号：R563.5[医药卫生—呼吸系统]