摘要
Abstract
Objective To investigate the effectiveness of rivaroxaban on acute pulmonary embolism in ischemic stroke patients with high risk of hemorrhage.Methods In a randomized controlled trial,sixty-two ischemic stroke patients with acute pulmonary embolism and high risk of hemorrhage were randomly assigned into two groups:study group and control group.Control group (31 cases) received subcutaneous injection of low molecular weight heparin (LMWH) once 12 hours,of which the dosage was adjusted with weight,one to three days later subsequently followed with warfarin,which the dosage was adjusted with INR,while the study group (31 cases) received oral rivaroxaban 10 mg once daily.Changes of PaO2,PaCO2,SaO2,visual analogue scale (VAS) for dyspnea,the St.George's respiratory questionnaire score(SGRQ),and echocardiography parameters before and 1,3,6 months after treatment were observed in both groups.The incidence of bleeding event or adverse event was compared between the two groups.Results Three and six months after the treatment,patients in both groups had a increased level of PaO2,PaCO2,SaO2,and right ventricular ejection fraction (RVEF);and a decreased level of VAS for dyspnea,SGRQ score,pulmonary artery systolic pressure(PASP),mean pulmonary artery pressure(MPAP),right atrial pressure (RAP),right ventricular pressure (RVP)(P＜0.05).When compared with the control group,PaO2,PaCO2,SaO2,and RVEF levels were significantly higher,and VAS for dyspnea,SGRQ score,PASP,MPAP,RAP,PVR were significantly lower in the study group (P＜0.05).The incidence of bleeding event or adverse event of the 2 groups was similar (P＞0.05).Conclusion Oral rivaroxaban therapy was effective for ischemic stroke patients with acute pulmonary embolism and high risk of hemorrhage after stroke.The risk of bleeding was similar to the conventional injection with LMWH.关键词
利伐沙班/低分子量肝素钠/脑卒中/肺栓塞Key words
Rivaroxaban/Low molecular weight heparin/Stroke/Pulmonary embolism分类
医药卫生
