达比加群酯联合心脉隆注射液对老年心力衰竭合并肺栓塞患者疗效及临床指标的影响

Effect of dabigatran etexilate combined Xinmailong injection on e fficacy and clinical indicators of elderly patients with heart failure and pulmonary embolism

目的探讨达比加群酯联合心脉隆注射液对老年慢性心力衰竭(CHF)合并肺栓塞(PE)患者疗效及临床指标的影响。方法收集2019年2月至2021年11月于泰兴市人民医院接受治疗的70例老年CHF合并PE患者的临床资料,根据治疗方式的不同将患者分为观察组和对照组。对照组采用心脉隆注射液联合常规治疗,观察组在对照组治疗的基础上联合应用达比加群酯治疗,每组35例。比较两组患者的临床疗效、心功能指标[左心室舒张末容积(LVEDV)、左心室收缩末容积(LVESV)、左心室射血分数(LVEF)、心排血量(CO)]、活动耐力指标[6分钟步行试验(6MWT)]、肺功能及血气指标[肺活量(VC)、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、肺泡-动脉血氧分压差(P_(A-a)O_(2))]、凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体(D-D)、国际标准化比值(INR)]及出血事件的发生率。结果观察组患者的临床总有效率高于对照组患者,临床疗效优于对照组患者,差异均有统计学意义(P<0.05)。治疗后,观察组患者的D-D水平、PA-aO_(2)均明显低于对照组患者,PT、APTT均明显长于对照组患者,INR、VC、PaO_(2)、PaCO_(2)均明显高于对照组患者,差异均有统计学意义(P<0.01)。观察组患者的出血事件发生率低于对照组患者,差异有统计学意义(P<0.05)。结论达比加群酯联合心脉隆注射液能够提高老年CHF合并PE患者的临床疗效,进一步改善患者的心功能、肺功能及血气指标、凝血功能。

Objective To investigate the effect of dabigatran etexilate combined Xinmailong injection on efficacy and clinical indicators of elderly patients with chronic heart failure(CHF)complicated with pulmonary embolism(PE).Method Clinical data of 70 elderly patients with CHF and PE admitted into Taixing People's Hospital from February 2019 to November 2021 were collected,and the patients were divided into control group(n=35,treated with Xinmailong injection combined with conventional treatment)and observation group(n=35,treated with dabigatran etexilate on the basis of treatment in the control group)according to different treatment methods.The clinical efficacy,cardiac function indexes[left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricle ejection fraction(LVEF),cardiac output(CO)],activity endurance index[six-minute walk test(6MWT)],lung function and blood gas indexes[vital capacity(VC),partial pressure of oxygen in arterial blood(PaO_(2)),partial pressure of carbon dioxide in arterial blood(PaCO_(2)),alveolar-artery oxygen partial pressure gradient(PA-aO_(2))]coagulation function indicators[prothrombin time(PT),activated partial thromboplastin time(APTT),D-dimer(D-D)and international normalized ratio(INR)]and the incidence of bleeding events were compared.Result The total clinical effective rate of the observation group was higher than that of the control group,and the clinical effect was better than that of the control group(P<0.05).After treatment,the D-D level and PA-aO_(2) of patients in the observation group were significantly lower than that in the control group,PT and APTT were significantly longer than those in the control group,and INR,VC,PaO_(2) and PaCO_(2) were significantly higher than those in the control group(P<0.01).The incidence of bleeding events in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Dabigatran etexilate combined Xinmailong injection can improve the clinical efficacy of elderly patients with CHF and PE,and further improve the patients'cardiac function,lung function,blood gas indexes and coagulation function.