利伐沙班用于急性肺栓塞的抗凝效果及对血清Hcy、BNP、TnI与D-D水平的影响

The Anticoagulant Effect of Rivaroxaban on Acute Pulmonary Embolism and its Effects on the Serum Hcy, BNP, TnI and D-D Levels

目的:探讨利伐沙班用于急性肺栓塞的抗凝效果及对血清脑钠肽(Brain natriuretic peptide,BNP)、肌钙蛋白I (Troponin I,TnI)、D-二聚体(D-Dimer,D-D)、同型半胱氨酸(homocysteine,Hcy)水平的影响。方法:选择2014年2月至2017年12月在我院进行治疗的(高)中危组急性肺栓塞患者106例,并将其随机分为观察组和对照组。对照组皮下注射低分子肝素钙搭配华法林治疗,观察组予以利伐沙班治疗,观察和比较两组患者的临床疗效、治疗前后血清BNP、TnI、D-D、Hcy水平的变化及不良反应的发生情况。结果:治疗后,观察组患者总有效率为94.37%,显著高于对照组(42.10%,P<0.05);观察组患者血清BNP、TnI、D-D、Hcy及肺动脉收缩压水平均显著低于对照组(P<0.05),而动脉收缩压、动脉血氧分压水平较对照组水平显著升高(P<0.05)。结论:利伐沙班应用于治疗急性肺栓塞的抗凝效果显著优于低分子肝素钙搭配华法林治疗,其可有效降低患者血清BNP、TnI、D-D、Hcy水平以及肺动脉收缩压。

Objective: To study the anticoagulant effect of rivaroxaban on the acute pulmonary embolism and its effects on the serum Hcy, BNP, Tn I and D-D levels. Methods: 106 patients with acute pulmonary embolism who were treated from February 2014 to December 2016 were selected as the research objects. The patients were randomly divided into the observation group and the control group, the control group was subcutaneously injected with low molecular heparin calcium, and the observation group was combined with rivaroxaban on the basis of control group. The changes of serum levels of BNP, TnI, D-D, Hcy before and after treatment and incidence of adverse events were compared between two groups. Results: After treatment, the total effective rate was 94.37% in the observation group, which was significantly higher than that of the control group(42.10%, P<0.05);the serum BNP, TnI, DD, Hcy and systolic blood pressure levels in the observation group were significantly lower than those in the control group(P<0.05), while the levels of arterial systolic and arterial oxygen pressure were significantly higher than those in the control group(P<0.05). Conclusion: The anticoagulant effect of rivaroxaban is significantly better than low molecular heparin calcium combined with warfarin in the treatment of acute pulmonary embolism, which can effectively reduce the serum BNP, TnI, d-d, Hcy levels and pulmonary artery systolic pressure of patients.