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-  2018 

利伐沙班在急性中危肺血栓栓塞合并下肢深静脉血栓患者治疗中的临床意义

DOI: doi:10.7507/1671-6205.201704018

Keywords: 利伐沙班, 肺血栓栓塞, 下肢深静脉血栓, 华法林

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Abstract:

目的 探讨利伐沙班在急性中危肺血栓栓塞合并下肢深静脉血栓患者治疗中的疗效及安全性。 方法 采用前瞻性随机对照研究的设计方法,收集 2010 年 1 月至 2017 年 3 月在湖南省人民医院住院治疗的 60 例急性中危肺血栓栓塞合并下肢深静脉血栓患者临床资料。依据治疗方式不同分为利伐沙班组和传统华法林组(对照组),各 30 例。在治疗后 10 d、20 d 和 30 d 比较两组的临床疗效及安全性。 结果 CT 肺动脉造影和超声心动图结果表明利伐沙班组右心室最大短轴、左心室最大短轴直径、右心室最大短轴与左心室最大短轴直径比值、肺动脉收缩压和主肺动脉直径值在治疗后 10 d、20 d 及 30 d 与对照组比较无显著差异(均 P>0.05),但两组组内不同时间点间比较,差异均有统计学意义(均 P<0.05)。利伐沙班组和对照组氨基末端 B 型脑钠肽在治疗后 10 d、20 d 和 30 d 显著降低,PO 2 值在治疗后 10 d、20 d 明显升高,而治疗后 30 d 与 20 d 比较无明显差异。D-二聚体在对照组和利伐沙班组治疗后 10 d 明显增高,利伐沙班组更明显,而在治疗后 20 d、30 d 降低,利伐沙班组下降更显著,且两组及组间比较差异均显著,有统计学意义(均 P<0.05)。 结论 利伐沙班治疗急性中危肺血栓栓塞合并下肢深静脉血栓患者临床疗效明显且安全,值得临床实施与推广应用

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