脑心通胶囊联合利伐沙班在急性肺动脉栓塞介入治疗中的应用及对血栓弹力图参数的影响

Application of Naoxintong Capsules Combined with Rivaroxaban in the Interventional Therapy of Acute Pulmonary Embolism and Influence on Thromboelastography Parameters

【目的】探讨脑心通胶囊联合利伐沙班在急性肺动脉栓塞(APE)介入治疗中的应用及对血栓弹力图参数的影响。【方法】200例在两院行APE介入治疗的患者,随机分为观察组和对照组,每组100例。对照组给予利伐沙班治疗,观察组在对照组基础上给予脑心通胶囊治疗。比较两组近期总有效率、动脉血气指标、凝血指标、血栓弹力图参数、炎症指标以及治疗过程中不良事件发生情况。【结果】观察组总有效率显著高于对照组(P<0.05)。治疗后,两组动脉血氧分压、动脉血二氧化碳分压、血栓弹力图参数(R值、K值、LY30)较基线水平升高,血栓弹力图参数(α角、MA值)、肺动脉压、D-二聚体、肿瘤坏死因子-α、高敏C反应蛋白、N端脑钠肽前体降低,活化部分凝血活酶时间、凝血酶原时间延长(P<0.05),且观察组患者的改善情况明显好于对照组(P<0.05)。两组不良事件发生率比较,差异无统计学意义(P>0.05)。【结论】脑心通胶囊联合利伐沙班在APE介入治疗中的抗凝疗效优于单药利伐沙班,能够更好地改善血栓弹力图参数,减轻机体炎症反应,且安全性较高。

【Objective】To investigate the application of Naoxintong capsule combined with rivaroxaban in interventional treatment of acute pulmonary embolism(APE)and its effect on thromboelastogram parameters.【Methods】A total of 200 patients who underwent APE intervention in two hospitals were randomly divided into the observation group and the control group,with 100 cases in each group.The control group was treated with rivaroxaban,while the observation group was treated with Naoxintong Capsule in addition to the treatment in the control group.The recent total effective rate,arterial blood gas index,coagulation index,thromboelastogram parameters,inflammatory index and adverse events during treatment were compared between the two groups.【Results】The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).After treatment,the arterial oxygen partial pressure,arterial carbon dioxide partial pressure and thromboelastogram parameters(R value,K value and LY30)in the two groups increased,if compared with the baseline level,while the thromboelastogram parameters(αAngle,MA value),pulmonary artery pressure,D-dimer,tumor necrosis factor-α,high sensitivity C-reactive protein and N-terminal probrain natriuretic peptide decreased,and the activated partial thromboplastin time and prothrombin time got prolonged(P<0.05).The improvement of patients in the observation group was significantly better than those in the control group(P<0.05).There was no significant difference in the incidence of adverse events between two group(P>0.05).【Conclusion】The anticoagulant effect of Naoxintong capsule combined with rivaroxaban in the interventional treatment of APE is better than that of rivaroxaban alone.It can significantly improve the parameters of thromboelastogram and reduce the inflammatory response.This method has high safety.