利伐沙班联合低分子量肝素钙治疗急性肺栓塞的疗效及对肺通气功能和血浆抗Xa活性水平的影响

Efficacy of rivaroxaban combined with low molecular weight heparin calcium in the treatment of acute pulmonary embolism and its effect on pulmonary ventilation function and plasma anti-Xa activity level

目的探究利伐沙班联合低分子量肝素钙治疗急性肺栓塞(APE)的疗效及对肺通气功能和血浆抗Xa活性水平的影响。方法选取2019年1月至2020年12月本院收治的78例APE患者作为研究对象,根据治疗方法不同分为对照组与实验组,每组39例。对照组采用低分子量肝素钙治疗,实验组在对照组基础上联合利伐沙班治疗,比较两组血液生化指标、症状缓解情况、肺通气功能情况、血浆抗Xa活性。结果实验组凝血酶原时间(PT)、纤维蛋白原(FIB)水平均高于对照组,C反应蛋白(CRP)、D-二聚体水平均低于对照组,差异有统计学意义(P<0.05)。实验组症状总缓解率为97.44%,高于对照组的84.62%,差异有统计学意义(P<0.05)。实验组呼吸做功(WOB)水平低于对照组,氧合指数(OI)、肺动态顺应性(Cdyn)均高于对照组,差异有统计学意义(P<0.05)。注射4、24 h后,实验组血浆抗Xa活性水平均高于对照组,差异有统计学意义(P<0.05)。结论利伐沙班联合低分子量肝素钙治疗APE疗效显著,能明显改善患者肺通气功能和血清Xa因子水平,值得临床推广应用。

Objective To investigate the efficacy of rivaroxaban combined with low molecular weight heparin calcium in the treatment of acute pulmonary embolism(APE)and its effect on pulmonary ventilation function and serum factor Xa level.Methods 78 patients with APE admitted to our hospital from January 2019 to December 2020 were selected as the research subjects,and they were divided into control group and experimental group according to different treatment methods,with 39 cases in each group.The control group was treated with low molecular weight heparin calcium,the experimental group was treated with rivaroxaban on the basis of the control group,and the blood biochemistry indexs,symptom relief,pulmonary ventilation function,and plasma anti-Xa activity were compared between the two groups.Results The levels of prothrombin time(PT)and fibrinogen(FIB)in the experimental group were higher than those in the control group,while the levels of C-reactionprotein(CRP)and D-dimer in the experimental group were lower than those in the control group,and the difference was statistically significant(P<0.05).The total remission rate in the experimental group was 97.44%,which was higher than 84.62%in the control group,and the difference was statistically significant(P<0.05).The level of work of breathing(WOB)in the experimental group was lower than that in the control group,while oxygenation index(OI)and dynamic compliance(Cdyn)were higher than those in the control group,and the difference was statistically significant(P<0.05).After 4 and 24 h of injection,the plasma anti-Xa activity level of the experimental group was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Rivaroxaban combined with low molecular weight heparin calcium has significant effect in the treatment of APE,and can significantly improve the pulmonary ventilation function and plasma anti-Xa activity level of patients,which is worthy of clinical application.