瑞舒伐他汀辅助治疗下肢深静脉血栓形成的临床疗效观察

Clinical effect observation of rosuvastatin in the adjuvant treatment of deep vein thrombosis of lower limbs

目的 探讨瑞舒伐他汀辅助治疗下肢深静脉血栓形成(deep vein thrombosis,DVT)的疗效。方法 选取2018年1月至2020年12月首都医科大学附属北京世纪坛医院DVT患者262例。按DVT治疗方式分为手术组(98例)和非手术组(164例),各组按1∶1比例随机分为干预组和对照组。干预组给予瑞舒伐他汀(10 mg/次,1次/d,晚饭后口服),对照组给予安慰剂片(由我院制剂室采用淀粉制成,性状及用法同瑞舒伐他汀),疗程均为4周,入组后第3、6、12个月末门诊复查随访。比较各组近期疗效,包括症状、肢体周径差、D-二聚体、静脉再通率;及远期疗效,包括DVT复发率和血栓后综合征(post-thrombotic syndrome,PTS)发生率及并发症。结果 262例患者中,男119例,女143例,年龄20~70岁,平均(57.6±13.7)岁;完成随访243例,失访19例,失访率7.25%。手术组中,两组近期疗效及远期疗效的比较,差异均无统计学意义(P>0.05);非手术组中,干预组近期疗效有效率高于对照组(92.86%比81.01%),DVT复发率和PTS发生率低于对照组(10.00%比39.13%,34.29%比50.63%),差异均有统计学意义(P<0.05)。结论 瑞舒伐他汀辅助治疗非手术DVT患者,可促进血栓消除和血管再通,预防远期DVT复发和PTS发生。

Objective To explore the safety and effectiveness of rosuvastatin in the adjuvant treatment of deep vein thrombosis(DVT) of lower limbs.Methods A total of 262 DVT patients from Beijing Shijitan Hospital affiliated to Capital Medical University from January 2018 to December 2020 were selected,and were divided into operation group(98 cases) and non-operation group(164 cases) according to the treatment of DVT.Each group was randomly divided into intervention group and control group according to the ratio of 1∶1.The intervention group was given rosuvastatin(10 mg/time,once a day,taken orally after dinner),and the control group was given placebo tablets(made of starch in the preparation room of our hospital,with the same characteristics and usage as rosuvastatin).The course of treatment was 4 weeks.The patients came to the outpatient clinic for follow-up at the end of the 3rd,6th,and 12th months after enrollment.The short-term curative effect including symptoms,limb circumference difference,D-dimer,vein recanalization rate and long-term curative effect including DVT recurrence rate,post-thrombotic syndrome(PTS) incidence and complications were analyzed.Results Among the 262patients,there were 119 males and 143 females,aged from 20 to 70 years,with an average age of(57.6 ± 13.7) years.A total of 243 cases were followed up and 19 cases were lost,with a follow-up loss rate of 7.25%.In the operation group,there was no statistically significant difference in the comparison of short-term and long-term curative effects between the intervention group and control group(P>0.05).In the non-operation group,the short-term effective rate of the intervention group was higher than that of the control group(92.86% vs.81.01%),while the recurrence rate of DVT and the incidence of PTS in the intervention group were lower than those in the control group(10.00% vs.39.13%,34.29% vs.50.63%),with statistical significance(P<0.05).Conclusions Rosuvastatin can promote the elimination of thrombus and vascular recanalization,and prevent the recurrence of DVT and the incidence of PTS in the long term.