疏血通与利伐沙班预防髋部手术后下肢静脉血栓形成

Shuxuetong Injection and Rivaroxaban Prevention of Deep Vein Thrombosis after Hip Surgery

目的:探讨疏血通注射液和利伐沙班对髋部手术后血浆内皮素(ET)、血栓素B2(TXB2)和6-酮-前列环素(6-Keto-PEG1a)水平的影响。方法:将68例髋部手术患者随机分为2组,每组34例,疏血通组静脉输注疏血通注射液6 m L/d,利伐沙班组口服利伐沙班10 mg/d。比较2组ET、TXB2、6-Keto-PGFla的变化。结果:疏血通组和利伐沙班组术后第14 d的ET含量较术后第3 d明显降低。术后第14 d两组的血栓素(TXB2)含量较治疗前明显降低,相反6-Keto-PGFla含量较治疗前明显升高。两组间血浆ET、TXB2、6-Keto-PGFla的含量水平差异无统计学意义(P>0.05)。疏血通注射液组DVT的总发生率为11.8%,利伐沙班组DVT的总发生率为8.8%。两组均为未出现明显不良反应。结论:疏血通注射液与利伐沙班均能安全有效地减少DVT的发生率,其作用机制可能是通过TXB2(TXA2)/6-Keto-PGFla(PGI2)/ET途径实现的。

Objective To investigate the effect of Shuxuetong injection and Rivaroxaban on the changes ofplasma endothelin（ET）, thromboxane B2（TXB2） and 6-keto prostaglandin（6-Keto-PEG1a） levels in the patientsafter hip orthopedic operation.MethodsSixty-eight cases of hip surgery were randomly divided into twogroups（34 cases in each group）. Both groups received the same basic treatment, and the Shuxuetong group wastreated with Shuxuetong injection 6 m L/d while the Rivaroxaban group was treated with Rivaroxaban 10 mg/d.ResultsThe postoperative fourteenth day＇s level of ET of the two group was significantly lower than that of thethird day＇s. Fourteen days after surgery, the thromboxane TXB2 was significantly lower than pretherapy, on thecontrast, the 6-Keto-PGFla was significantly higher than pretherapy. The level of plasma ET, TXB2, or 6-Ke-to-PGFla was of no significant difference between the two groups（P 0.05）. The incidence of deep vein thrombo-sis（DVT） in Shuxuetong group was 11.8%, and the incidence of DVT in rivaroxaban group was 8.8%. No obvi-ous adverse reactions were found between the two groups.ConclusionShuxuetong injection and Rivaroxabancan safely and effectively reduce the incidence of DVT, and its mechanism may be through the TXB2（TXA2）/6-Keto-PGFla（PGI2）/ET pathway.