不同抗凝治疗方法治疗肺栓塞中危患者的效果比较

Comparison of the Effects of Different Anticoagulation Therapies in the Treatment of Intermediate-risk Patients with Pulmonary Embolism

目的:比较不同抗凝治疗方法治疗肺栓塞中危患者的效果。方法:将2019年1月—2023年7月北京怀柔医院收治的120例肺栓塞中危患者随机分为对照组(n=60)、观察组(n=60)。对照组采用低分子肝素、华法林治疗,观察组采用利伐沙班治疗。比较两组实验室指标、心功能、治疗效果及不良反应发生率。结果:治疗后,两组活化部分凝血活酶时间延长,D-二聚体、血清肌钙蛋白I、脑利钠肽水平降低,观察组活化部分凝血活酶时间长于对照组,D-二聚体、血清肌钙蛋白I、脑利钠肽水平低于对照组(P<0.05)。治疗后,两组右心室舒张末期内径、主肺动脉内径、肺动脉收缩压水平低于治疗前(P<0.05)。观察组治疗总有效率高于对照组(P=0.004)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:应用利伐沙班治疗中危肺栓塞患者,可改善实验室指标,临床疗效更好,用药方便,且不会明显增加不良反应发生率,值得临床推广。

Objective:To compare the effects of different anticoagulation therapies in treating patients with intermediate-risk pulmonary embolism.Methods:One hundred and twenty patients with intermediate-risk of pulmonary embolism admitted to Beijing Huairou Hospital from January 2019 to July 2023 were randomly divided into the control group(60 cases)and the observation group(60 cases).The control group was treated with low molecular heparin and warfarin,and the observation group was treated with rivaroxaban.Laboratory indexes,cardiac function,therapeutic effect and incidence of adverse reactions were compared between the two groups.Results:After treatment,activated partial thromboplastin time was prolonged,D-dimer,serum troponin I and brain natriuretic peptide levels were decreased in both groups,and activated partial thromboplastin time was longer in the observation group than in the control group,and the levels of D-dimer,serum troponin I,and brain natriuretic peptide were lower than those in the control group(P<0.05).After treatment,the levels of right ventricular end diastolic diameter,main pulmonary artery diameter,and pulmonary artery systolic pressure of the two groups were lower than those before treatment(P<0.05).The total effective rate of treatment in the observation group was higher than that in the control group(P=0.004).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The application of rivaroxaban treatment for intermediate-risk pulmonary embolism can improve the laboratory indexes,has better clinical efficacy,is convenient to use,and does not significantly increase the incidence of adverse reactions,which is worthy of clinical promotion.