利伐沙班治疗老年急性肺栓塞患者的临床疗效及对生活质量的影响

Rivaroxaban treatment in elderly patients with acute pulmonary embolism and its effect on quality of life

目的探究利伐沙班治疗老年急性肺栓塞患者的临床疗效及对生活质量的影响。方法选取2018年3月至2020年3月中国人民解放军空军特色医学中心收治的80例老年急性肺栓塞患者临床资料,根据用药种类不同分为观察组(n=38)和对照组(n=42)。对照组患者接受华法林联合低分子肝素治疗,观察组患者接受利伐沙班联合低分子肝素治疗,比较两组患者症状缓解的时间、动脉血气指标[血氧饱和度(SaO2)、氧分压、二氧化碳(CO2)分压]、凝血功能指标[D-二聚体、纤维蛋白原、血浆凝血酶原时间(PT)和活化部分凝血酶原时间(APTT)水平]、生活质量和不良反应发生率。结果治疗4个月后,观察组患者缓解时间均短于对照组患者,PT和APTT均长于对照组患者,SaO2、氧分压水平和生活质量评分均高于对照组患者,CO2分压、D-二聚体和纤维蛋白原水平均低于对照组患者,差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论利伐沙班治疗老年急性肺栓塞,能降低患者的D-二聚体和纤维蛋白原水平,调节凝血功能和动脉血气指标,缩短症状缓解时间,提高生活质量。

Objective To explore the clinical efficacy of rivaroxaban and its effect on quality of life in elderly patients with acute pulmonary embolism.Method The clinical data of 80 elderly patients with acute pulmonary embolism admitted to PLA Air Force Characteristic Medical Center from March 2018 to March 2020 were selected.The patients were divided into the observation group(n=38,treated with rivaroxaban and low molecular weight heparin)and the control group(n=42,treated with warfarin and low molecular weight heparin).The time to symptom remission,arterial blood gas indexes[oxygen saturation(SaO2),partial pressure of oxygen,partial pressure of carbon dioxide(CO2)],coagulation function indexes[D-dimer,fibrinogen,plasma prothrombin time(PT)and activated partial prothrombin time(APTT)levels],quality of life and incidence of adverse reactions were compared between the two groups.Result After 4 months of treatment,the time to remission in the observation group was shorter than that in the control group;PT and APTT were longer than those in the control group;the scores of SaO2,oxygen partial pressure and quality of life were higher than those of the control group;CO2 partial pressure,D-dimer and fibrinogen levels were lower than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Rivaroxaban can reduce the levels of D-dimer and fibrinogen,regulate coagulation function and arterial blood gas index,shorten symptom time to remission and improve quality of life in elderly patients with acute pulmonary embolism.