利伐沙班用于肺栓塞抗凝治疗的效果、不良反应发生率及对患者血管内皮功能的影响分析

Effects of Rivaroxaban on anticoagulant therapy for pulmonary embolism, incidence of adverse reactions and impact analysis of vascular endothelial function in patients with pulmonary embolism

目的探讨利伐沙班用于肺栓塞抗凝治疗的效果、不良反应发生率及对患者血管内皮功能的影响。方法 280例急性肺栓塞患者,随机分为观察组与对照组,各140例。观察组给予利伐沙班治疗,对照组给予华法林治疗。观察两组血管内皮功能指标、治疗效果及不良反应发生率。结果两组患者治疗后的D-二聚体、蛋白C(PC)、血浆抗凝蛋白S(PS)、组织型纤溶酶原激活剂(t-PA)、内皮素-1(ET-1)、血浆6-酮-前列腺素F1α(6-K-PGF1α)、血栓烷素B2(TXB2)、一氧化氮(NO)均优于本组治疗前,差异具有统计学意义(P<0.05)。观察组治疗总有效率91.43%高于对照组的90.00%,但差异无统计学意义(P>0.05)。观察组不良反应发生率4.29%显著低于对照组的18.57%,差异具有统计学意义(χ2=14.113,P<0.05)。结论临床上,对急性肺栓塞患者应用利伐沙班进行抗凝治疗,疗效显著,不良反应发生率低,且对患者血管内皮功能的恢复有积极影响,值得推广。

Objective To investigate the effects of Rivaroxaban on anticoagulant therapy for pulmonary embolism, incidence of adverse reactions and impact of vascular endothelial function in patients with pulmonary embolism. Methods A total of 280 patients with acute pulmonary embolism were randomly divided into observation group and control group, 140 cases in each group. The observation group was treated with Rivaroxaban, the control group was treated with Warfarin. The vascular endothelial function indexes, therapeutic effect and incidence of adverse reactions were observed between the two groups. Results The D-dimer, protein C（PC）, plasma anticoagulant S（PS）, tissue type plasminogen activator（t-PA）, endothelin-1（ET-1）, Plasma 6-ketone prostaglandin F1α（6-K-PGF1α）, Thromboxane B2（TXB2） and nitric oxide（NO） of the two groups after treatment were all significantly better than those before treatment, the differences were statistically significant（P〈0.05）. The total effective rate of the observation group was 91.43%, which was slightly higher than 90.00% of the control group, but the difference was not statistically significant（P〈0.05）. The incidence of adverse reactions in the observation group was 4.29%, which was significantly lower than 18.57% in the control group, the difference was statistically significant（χ2=14.113, P〈0.05）. Conclusion In clinical, the curative effect of anticoagulant therapy with Rivaroxaban in the treatment of patients with acute pulmonary embolism is remarkable, with low incidence of adverse reactions, and it has a positive effect on the recovery of vascular endothelial function, is worth popularizing.