摘要
Abstract
Objective To observe the clinical efficacy and safety of alteplase combined with rivaroxaban in the treatment of acute deep vein thrombosis(DVT)in elderly obese patients.Methods Elderly obese patients with DVT were divided into control group and treatment group according to random number table method.The control group was treated with 10 mg·d-1 rivaroxaban tablets orally.The treatment group was treated with 0.9 mg·kg-1·d-1 alteplase on the basis of the control group.Both groups were treated for 1 week.Clinical efficacy,coagulation function indexes,lower limb venous blood flow mechanics indexes,inflammatory factors and vascular endothelial function related indexes,relative expression level of miR-374b-5p,occurrence of adverse drug reactions and recurrence within 3 months were compared between the two groups.Results A total of 80 patients were enrolled in the treatment group and the control group,respectively.After treatment,the total effective rate of treatment group and control group were 92.50％(74 cases/80 cases)and 81.25％(65 cases/80 cases),respectively,and the difference was statistically significant(P＜0.05).After treatment,the fibrinogen levels of treatment group and control group were(3.58±0.83)and(3.91±1.04)g·L-1,respectively;D-dimer levels were(2.18±0.74)and(2.49±0.93)μg·mL-1,respectively;platelet activating factor were(115.42±10.43)and(119.74±11.37)μg·L-1,respectively;prothrombin time were(12.95±1.16)and(13.41±1.27)s,respectively;the maximum blood flow velocity were(29.19±6.74)and(26.93±4.58)cm·s-1,respectively;the blood flow were(92.17±9.61)and(88.63±8.75)mL·min-1,respectively;endothelial vasoconstricting peptide-1 were(51.97±4.86)and(54.02±4.92)pg·mL-1;the relative expression levels of miR-374b-5p were 2.18±0.73 and 2.49±0.85,respectively.The above indexes of the treatment group were statistically significant compared with the control group(all P＜0.05).Bleeding symptoms were the main adverse drug reactions in both groups.The total incidence of adverse drug reactions in treatment group and control group was 10.00％and 13.75％,respectively,with no statistical significance(P＞0.05).The 3-month recurrence rates of treatment group and control group was 6.25％and 16.25％,respectively,and the difference was statistically significant(P＜0.05).Conclusion Alteplase combined with rivaroxaban has good clinical efficacy in the treatment of elderly obese patients with DVT,which can improve the blood flow of patients,reduce inflammatory response,and has high safety.关键词
阿替普酶注射液/利伐沙班片/老年肥胖/急性下肢深静脉血栓/血小板活化功能Key words
alteplase injection/rivaroxaban tablet/old age obesity/acute deep venous thrombosis of lower extremity/platelet activation function分类
医药卫生
