利伐沙班和低分子肝素用于部分实体恶性肿瘤合并静脉血栓栓塞症抗凝的疗效分析

Curative effect of the rivaroxaban and the low-molecular weight heparin anticoagulation in patients with active malignant tumors combined with venous thromboembolism

目的比较利伐沙班与低分子肝素(low-molecular weight heparin,LMWH)在活动期恶性肿瘤合并静脉血栓栓塞症(venous thromboembolism,VTE)患者中的抗凝有效性与安全性。方法本研究为前瞻性研究,选取2015年1月至2016年8月复旦大学附属中山医院收治的活动期恶性肿瘤并发急性VTE患者。分别采用利伐沙班或LMWH进行抗凝治疗。对患者随访90天,观察疗效、治疗过程有无复发及出血,并对总有效率、复发及出血等不良事件进行统计学分析。结果入组67例患者。LMWH组37例,其中男16例(43.2%),年龄38~84岁;利伐沙班组30例,其中男12例(40.0%),年龄45~88岁。两组患者的基本情况差异无统计学意义。利伐沙班组和LMWH组在有效性(P=0.699),复发事件(P=0.774)、出血事件(P=0.490)及不良事件(P=0.448)差异均无统计学意义。结论利伐沙班与低分子肝素在活动期恶性肿瘤合并VTE患者的抗凝作用有相似的安全性和有效性。

Objective To investigate the efficacy and safety of rivaroxaban in contrast with lowmolecular weight heparin（LMWH）in patients with active malignant tumor combined with venous thromboembolism（VTE）. Methods This study was a prospective case-control study.All cases were from Zhongshan Hospital,Fudan University between Jan.,2015 and Aug.,2016.They were treated with either rivaroxaban or LMWH for anticoagulation.Patients were followed up for 90 days to observe the treatment efficacy,recurrence and bleeding events.The total efficiency,recurrence events,bleeding events and adverse events were statistically analyzed. Results A total of 67 patients were enrolled in this study.Among them,37 cases aged 38-84 years old were assigned to LMWH group,of which 16cases（43.2%）were male.Another 30 cases aged 45-88 years old were assigned to rivaroxaban group and 12cases（40.0%）were male.There was no statistically significant difference between the two groups.The total effective rate（P=0.699）,recurrence events（P=0.774）,bleeding events（P=0.490）and adverse events（P=0.448）between the LMWH group and the rivaroxaban group had no significant difference. Conclusions Rivaroxaban and LMWH anticoagulation had similar safety and efficacy in patients with active malignant tumor combined with VTE.