基于超声影像学探讨利伐沙班治疗老年卒中下肢深静脉血栓的效果

To investigate the effect of Rivaroxaban in the treatment of elderly patients with stroke and lower extremity deep vein thrombosis based on ultrasonography

目的 基于超声影像学方法,探讨利伐沙班在脑卒中下肢深静脉血栓(Deep Vein Thrombosis, DVT)中的治疗效果。方法 选取2021年6月至2022年6月北京小汤山医院收治的86例脑卒中后下肢深静脉血栓的老年患者,入选患者均接受彩色多普勒超声影像学检查,经服用利伐沙班治疗后,对比治疗前后患者的临床症状、凝血功能、血液流变学指标以及二维声像图指标。结果 治疗后患者肢围、色素沉着评分以及疼痛评分均低于治疗前(P<0.05);患者治疗后红细胞聚集指数(The red cell aggregation index, RCAI)、血浆黏度(plasma viscosity, CP)、红细胞比容(Hematocrit, HCT)、D-二聚体均低于治疗前(P<0.05);而且治疗后患者凝血酶原时间(Prothrombin time, PT)、凝血酶时间(Thrombin time, TT)、活化部分凝血活酶时间(activated partial thromboplastin time, APTT)均高于治疗前,纤维蛋白原(Fibrinogen, FIB)低于治疗前(P<0.05)。此外,DVT患者治疗后管腔内回声清晰患者占比、血管压缩性良好占比、管壁内膜光滑占比均高于治疗前(P<0.05),而管腔内径占比与治疗前相比无明显差异(P>0.05)。结论 利伐沙班治疗下肢深静脉血栓效果显著,能够改善血液黏稠度和凝血功能,利用超声影像学检查也能为DVT治疗提供参考依据。

Objective To investigate the therapeutic effect of Rivaroxaban in stroke patients with deep vein thrombosis(DVT)based on ultrasound imaging.Methods From June 2021 to June 2022,86 elderly patients with deep venous thrombosis of lower extremities after stroke admitted to Beijing Xiaotangshan Hospital were selected.All the selected patients underwent color Doppler ultrasound imaging examination.After treatment with Rivaroxaban,the clinical symptoms,coagulation function,hemorheology index and two-dimensional ultrasound index of the patients before and after treatment were compared.Results After treatment,the limb circumference,pigmentation score and pain score of the patients was all lower than those before treatment(P<0.05).After treatment,the red cell aggregation index(RCAI),plasma viscosity(CP),Hematocrit(HCT)and D-dimer was lower than those before treatment(P<O.05);and after treatment,prothrombin time(PT),thrombin time(TT),the activated partial thromboplastin time(APTT)was higher than that before treatment,and the fibrinogen(FIB)was lower than that before treatment(P<0.05).The ratio of vascular compressibility,the proportion of good vascular compressibility,and the proportion of smooth intima was higher than those before treatment(P<0.05),while the proportion of lumen inner diameter had no significant difference compared with before treatment(P>0.05).Conclusion Rivaroxaban has a significant effect in the treatment of lower extremity deep vein thrombosis,and can improve blood viscosity and coagulation function.Ultrasound imaging examination can also provide a reference for DVT treatment.