低剂量利伐沙班对深静脉血栓形成疗效分析

Effect of low dose rivaroxaban on deep vein thrombosis

目的:探讨低剂量利伐沙班在深静脉血栓栓塞维持治疗的可行性与疗效。方法:56例深静脉血栓形成患者,依据使用药物方案分成低剂量利伐沙班治疗组(低剂量组)和常规剂量利伐沙班治疗组(常规剂量组)各28例,比较2组入院时(0周)及治疗后第1、2、3、4、8、12周患者D-二聚体水平及入院时(0周)和治疗后第3、4、8、12周下肢周径,同时比较2组并发肺动脉栓塞人数及全组出现出血事件的频次。结果:不同时间点2组患者D-二聚体水平变化差异无统计学意义(P>0.05),下肢周径变化差异亦无统计学意义(P>0.05);低剂量组1例患者并发肺动脉栓塞,常规剂量组3例患者并发肺动脉栓塞,但差异无统计学意义(P>0.05);低剂量组发生2次出血事件(鼻出血和牙龈出血各1次),常规剂量组发生8次出血事件(鼻出血3次、牙龈出血3次和皮下渗血2次),常规剂量组出血风险较低剂量组高,差异有统计学意义(P<0.05)。结论:在下肢深静脉血栓形成维持阶段,低剂量与常规剂量利伐沙班抗凝有同样效果,并不会增加肺动脉栓塞发生率,且发生出血事件更少。

Objective:To investigate the feasibility and efficacy of low-dose rivaroxaban in the maintenance treatment of deep vein thrombosis.Methods:A total of 56 patients with deep vein thrombosis were divided into low-dose rivaroxaban treatment group(low-dose group)and conventional dose rivaroxaban treatment group(conventional dose group),with 28 cases in each group.The D-dimer level and lower limb diameter were compared between the two groups at admission(week 0)and at 1,2,3,4,8,12 weeks after treatment,and at admission(week 0)and at 3,4,8,12 weeks after treatment.The number of patients with pulmonary embolism and the frequency of bleeding events were also compared between the two groups.Results:There was no significant difference in D-dimer level or the circumference diameter of lower limbs between the two groups at different time points(P>0.05);Pulmonary embolism occurred in 1 patient in the low-dose group and 3 patients in the conventional dose group,the difference was not statistically significant(P>0.05);There were 2 bleeding events in the low-dose group(1 each for nose bleeding and gingival bleeding),and 8 bleeding events in the conventional dose group(3 for nose bleeding,3 for gingival bleeding and 2 for subcutaneous bleeding).The risk of bleeding in the conventional dose group was higher than that in the low-dose group,and the difference was statistically significant(P<0.05).Conclusion:In the maintenance phase of lower limb deep vein thrombosis,low-dose and conventional-dose rivaroxaban have the same anticoagulant effect and do not increase the incidence of pulmonary embolism.In addition,the risk of bleeding events is lower.