利伐沙班治疗不同D-D表达水平下肢深静脉血栓患者的效果

The Effect of Rivaroxaban in the Treatment of Lower Limb Deep Vein Thrombosis Patients with Different Levels of D-D Expression

目的:分析利伐沙班治疗不同D-二聚体(D-dimer,D-D)表达水平下肢深静脉血栓患者的效果。方法:选取松滋市人民医院2022年10月—2023年10月收治的100例下肢深静脉血栓患者为研究对象,以D-D水平0.6 mg/L为临界值,将D-D>0.6 mg/L的49例患者作为高表达组,D-D≤0.6 mg/L的51例患者作为低表达组。两组均采用利伐沙班治疗。检测对比两组血流动力学、血液流变学、内皮功能指标、炎症因子、治疗效果。结果:治疗后,两组中心静脉压(central venous pressure,CVP)、平均动脉压(mean arterial pressure,MAP)水平均较治疗前升高,且低表达组均高于高表达组,血浆黏度、全血低切黏度、全血高切黏度、血管性血友病因子(von willebrand factor,vWF)、内皮素(endothelin,ET)、巨噬细胞炎症蛋白1α(macrophage inflammatory protein 1α,MIP-1α)、C反应蛋白(C reactive protein,CRP)水平均较治疗前降低,且低表达组均低于高表达组(P<0.05)。与高表达组相比,低表达组治疗总有效率较高,差异有统计学意义(P<0.05)。结论:D-D≤0.6 mg/L的下肢深静脉血栓患者采用利伐沙班治疗后血流动力学、血液流变学改善,内皮损伤、炎症反应减轻较为明显,效果更为理想。

Objective:To analyze the effect of Rivaroxaban in the treatment of lower limb deep vein thrombosis with different D-dimer(D-D)expression levels.Method:A total of 100 patients with lower limb deep vein thrombosis admitted to Songzi People's Hospital from October 2022 to October 2023 as the research subjects,with a D-D level of 0.6 mg/L as the critical value,49 patients with D-D>0.6 mg/L were selected as the high expression group,and 51 patients with D-D≤0.6 mg/L were selected as the low expression group.Both groups were treated with Rivaroxaban.The hemodynamics,hemorheology,endothelial function indexes,inflammatory factors and therapeutic effect of two groups were detected and compared.Result:After treatment,the levels of central venous pressure(CVP)and mean arterial pressure(MAP)in two groups were increased compared to those before treatment,and those in the low expression group were higher than those in the high expression group,and plasma viscosity,whole blood low shear viscosity,whole blood high shear viscosity,von willefibrilia factor(vWF),endothelin(ET),macrophage inflammatory protein 1α(MIP-1α)and C reactive protein(CRP)levels were decreased compared to those before treatment,and those in low expression group were lower than those in the high expression group(P<0.05).Compared with high expression group,the total effective rate of low expression group was higher,the difference was statistically significant(P<0.05).Conclusion:Patients with deep vein thrombosis in the lower limbs with D-D≤0.6 mg/L showed improvement in hemodynamics and hemorheology after treatment with Rivaroxaban,with significant reduction in endothelial injury and inflammatory response,resulting in more ideal outcomes.