【摘要】 目的探讨利伐沙班对急性非高危肺血栓栓塞症患者细胞因子及右心功能的影响。方法选取确诊急性非高危肺血栓栓塞症患者104例,随机分为对照组(n=52)和观察组(n=52),对照组给予常规治疗,观察组在对照组基础上采用利伐沙班治疗。比较2组总有效率、细胞因子指标[D-二聚体(D-D)、C反应蛋白(CRP)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)]、右心功能指标[右室面积变化分数(RVFAC)、右心室心肌做功(Tei)指数、右心室与左心室舒张期横径比值(RVDD/LVDD)、右心室游离壁三尖瓣环收缩期位移(TAPSE)]、血气分析指标{动脉血氧分压[pa(O2)]、动脉血二氧化碳分压[pa(CO2)]、心率(HR)}、不良反应及健康调查表(SF-36)评分情况。结果治疗后,观察组总有效率高于对照组,D-D、IL-10、CRP、TNF-α水平低于对照组,Tei指数、RVDD/LVDD低于对照组,RVFAC、TAPSE高于对照组,pa(O2)、pa(CO2)高于对照组,差异均有统计学意义(P <0.05)。2组不良反应发生率差异无统计学意义(P> 0.05)。观察组SF-36评分高于对照组,差异有统计学意义(P <0.05)。结论利伐沙班治疗急性非高危肺血栓栓塞症患者疗效确切,可有效降低D-D的水平,改善血管内纤维溶解性与凝血功能,抑制炎症反应,改善右心功能和血气指标,且安全性较好。更多还原

【Abstract】 Objective To explore the effect of rivaroxaban on cytokine and right ventricular function in patients with acute non-high risk pulmonary thromboembolism. Methods Totally 104 patients diagnosed as acute non-high risk pulmonary thromboembolism were selected and randomly divided into control group( n = 52) and observation group( n = 52). The patients in the control group were given routine treatment,while the patients in the observation group were given rivaroxaban on the basis of the control group. The total effective rate,cytokine indexes[D-dimer( D-D),C reactive protein( CRP),interleukin-10( IL-10) and tumor necrosis factor-α( TNF-α) ],right ventricular function indexes[right ventricular fractional area change( RVFAC),right ventricular myocardial performance( Tei)index,ratio of right ventricular to left ventricular diastolic transverse diameter( RVDD/LVDD),right ventricular free wall tricuspid annulus systolic displacement( TAPSE) ],blood gas analysis indexes such as arterial oxygen partial pressure[pa( O2) ],arterial blood carbon dioxide partial pressure[pa( CO2) ],heart rate( HR),adverse reactions and short-form health questionnaire( SF-36) score before and after treatment were compared between the two groups. Results After treatment,the total effective rate of the observation group was higher than that of the control group,the levels of D-D,IL-10,CRP and TNF-α were lower than those in the control group,the Tei index and RVDD/LVDD were lower than those in the control group,RVFAC and TAPSE were higher than those in the control group,pa( O2) and pa( CO2) were also higher than those in the control group,and all the differences were significant( P < 0. 05). There was no significant difference in the incidence of adverse reactions between the two groups( P > 0. 05). The score of SF-36 in the observation group was significantly higher than that in the control group( P < 0. 05). Conclusion Rivaroxaban is effective in the treatment of acute non-igh risk pulmonary thromboembolism,which can effectively reduce the level of D-D,improve intravascular fibrinolysis and coagulation function,inhibit inflammatory reaction,improve right ventricular function and blood gas indexes,and safety is relatively higher.更多还原