磺达肝素钠与华法林治疗癌症患者意外检出肺栓塞的临床比较

Clinical efficacy of fondaparinux and warfarin in the treatment of unsuspected pulmonary embolism in patients with cancer

目的比较磺达肝素钠与华法林治疗癌症患者意外检出肺栓塞的临床疗效。方法收集2010年1月至2014年12月我院72例意外检出肺栓塞的恶性肿瘤患者,随机分为华法林组(36例,给予口服华法林,5 mg/d,1次/d,维持国际标准化比率在正常值2.0~3.0倍之间)和磺达肝素钠组(36例,给予皮下注射磺达肝素钠,2.5 mg/d,1次/d),观察两组患者连续治疗90 d后临床疗效、治疗结束1年内肺栓塞复发率及药物不良反应。结果两组患者连续治疗90 d后,磺达肝素钠组疗效显著好于华法林组(P<0.05);磺达肝素钠组出血患者例数显著低于华法林组(P<0.05);两组患者治疗结束1年内肺栓塞复发率比较差异无统计学意义(P>0.05)。结论磺达肝素钠治疗癌症患者意外检出肺栓塞的疗效优于华法林,不良反应少,具有临床应用价值。

Objective To evaluate the clinical efficacy of fondaparinux and warfarin in the treatment of unsus- pected pulmonary embolism in patients with cancer. Methods Totally 72 cancer patients with unsuspected pulmonary embolism from January 2010 to December 2014 were enrolled, and were randomly divided into warfarin group and fondaparinux group. Warfarin group （ n = 36 ） received warfarin ,5 mg orally, once daily, which was maintained at inter- national normalized ratio of 2.0 - 3.0 during treatment. Fondaparinux group （ n = 36 ） received fondaparinux, 2. 5 mg subcutaneously, once daily. The clinical efficacy of the two groups were observed for 90 d and followed up for 1 year, and adverse drug reactions were also evaluated. Results The clinical efficacy of fondaparinux group was significantly better than that of warfarin group （ P 〈 0. 05 ） during 90 d significantly lower than that of warfarin group （ P 〈 0. 05 ） of treatment. The bleeding rate of fondaparinux group was ~ There was no significant difference in disease recurrence during 1 year follow-up between the two groups. Conclusion Fondaparinux has better curative effect in the treatment of unsuspected pulmonary embolism in patients with cancer than warfarin with few adverse reactions, and it has clinical application value.