阿加曲班对恶性肿瘤合并急性下肢深静脉血栓患者C反应蛋白及疗效的影响

Effect of argatroban on C-reactive protein and therapeutic efficacy in patients with malignant tumor complicated by acute lower limbs deep venous thrombosis

目的 探讨阿加曲班对恶性肿瘤合并急性下肢深静脉血栓（DVT）患者血清C反应蛋白（CRP）及疗效的影响。方法 56例恶性肿瘤合并急性下肢DVT患者按随机数字表法分为观察组和对照组各28例，观察组给予阿加曲班抗凝治疗，对照组给予尿激酶溶栓、华法林抗凝等治疗。检测观察组和对照组在治疗前、治疗14 d血清CRP浓度，比较观察组和对照组治疗后下肢深静脉再通情况和疗效。结果 治疗前观察组与对照组血清CRP浓度分别为（46.44±28.82）mg／L、（45.96±29.40）mg／L，差异无统计学意义 （F＝0.004，P＝0.951）。治疗14 d后观察组和对照组CRP浓度均下降，分别为（16.97±10.22）mg／L、（31.63±18.07）mg／L，与治疗前比较差异均有统计学意义（F＝25.996，P＜0.05；F＝4.828，P＜0.05），且治疗后观察组CRP浓度低于对照组（F＝13.965，P＜0.01）。治疗后观察组血管再通率（96.43 %，27／28）高于对照组（67.86 %，19／28）（χ2＝8.204，P＝0.017），治疗后观察组总有效率（96.43 %，27／28）也高于对照组（75.00 %，21／28）（χ2＝6.205，P＝0.045）。结论 阿加曲班可降低恶性肿瘤合并急性下肢DVT患者血清CRP浓度，提高疗效。

Objective To investigate the effect of argatroban on C-reactive protein（CRP） and therapeutic efficacy in patients of malignant tumor complicated by acute lower limbs deep venous thrombosis （DVT）. Methods 56 patients of malignant tumor complicated by acute lower limbs DVT were randomly divided into two groups. In observation group （n = 28）, argatroban was given intravenously as anticoagulation. Urokinase as thrombolysis and warfarin as anticoagulation were used in the control group （n = 28）. The concentrations of serum CRP were detected before treatment and on the 14th day of post-treatment in observation group and control group. Recanalization and therapeutic effect of DVT were compared. Results Before treatment, there was no significant differences in the serum CRP concentrations between observation group and control group [（46.44±28.82） mg/L vs （45.96±29.40） mg/L, F = 0.004, P = 0.951]. On the 14th day of post-treatment, the CRP concentrations in observation group and control group were lower than those of pre-treatment （F = 25.996, P 〈 0.05, F = 4.828, P 〈 0.05）. Compared with the 14th day of post-treatment, the CRP concentration of observation group was lower than that of control group [（16.97±10.22） mg/L vs （31.63±18.07） mg/L, F = 13.965, P 〈 0.01]. Recanalization rate of observation group on the 14th day of post-treatment （96.43 %, 27/28） was higher than that in control group （67.86 %, 19/28） （χ2 = 8.204, P = 0.017）. Therapeutic effect rate of observation group on the 14th day of post-treatment （96.43 %, 27/28） was higher than that in control group （75.00 %, 21/28） （χ2 = 6.205, P = 0.045）. Conclusion Argatroban can decrease serum level of CRP in patient of malignant tumor complicated by acute lower limbs DVT, which is favorable for improvement of clinical effectiveness.