口服抗凝药对非急性期下肢深静脉血栓并HAPC病人的疗效评价

EVALUATION OF THE THERAPEUTIC EFFICACY OF ANTICOAGULANTS ON NON-ACUTE DEEP VEIN THROMBOSIS OF THE LOWER EXTREMITIES WITH HIGH-ALTITUDE POLYCYTHEMIA

目的研究非急性期下肢深静脉血栓(DVT)合并高原红细胞增多症(HAPC)病人口服抗凝药物疗效及并发症发生率。方法收集青海省人民医院血管外科住院治疗的DVT合并HAPC病人151例,随机分为两组。对照组给予华法林治疗,研究组给予利伐沙班治疗,观察治疗前后凝血酶原时间(PT)、部分凝血活酶时间(APTT)、纤维蛋白原(FIB)浓度、凝血酶时间(TT)、血清D-二聚体(D-Dimer)水平、血栓复发率与出血等凝血功能指标。结果治疗后两组PT、APTT、TT和血流速度均上升,FIB、D-Dimer水平均下降(t=2.198~24.924,P<0.05);研究组FIB、TT、D-Dimer和血流速度等治疗前后差值高于对照组(t=4.833~85.554,P<0.05)。对照组血栓复发10例(13.33%),研究组为3例(3.95%),差异有统计学意义(χ^(2)=4.227,P<0.05)。结论利伐沙班治疗非急性期下肢DVT合并HAPC效果较好,可作为临床首选治疗药物之一。

Objective To investigate the therapeutic efficacy and incidence of complications of oral anticoagulants in patients with non-acute deep venous thrombosis(DVT)of the lower extremities and high-altitude polycythemia(HAPC).Methods A total of 151 patients with DVT and HAPC hospitalized in the Department of Vascular Surgery of Qinghai Provincial People’s Hospital were enrolled and randomly divided into two groups.The control group was treated with warfarin,and the study group was treated with rivaroxaban.The two groups were observed for the changes in prothrombin time(PT),activated partial thromboplastin time(APTT),concentration of fibrin(FIB),thrombin time(TT),serum D-Dimer level,recurrence rate of thrombosis,and bleeding index after treatment.Results After treatment,the levels of PT,APTT,and TT and blood flow velocity significantly increased,while the levels of FIB and D-Dimer significantly decreased in both groups(t=2.198-24.924,P<0.05).The differences in the levels of FIB,TT,and D-Dimer and blood flow velocity before and after treatment in the study group were signi-ficantly greater than those in the control group(t=4.833-85.554,P<0.05).There was a significant difference in the recurrence of thrombosis,with 10 cases(13.33%)in the control group and 3 cases(3.95%)in the study group(χ^(2)=4.227,P<0.05).[WTHX]Conclusion Rivaroxaban has a favorable effect in the treatment of non-acute DVT of the lower extremities complicated by HAPC and can be used as one of the preferred drugs in clinical practice.