中国药物经济学2026，Vol.21Issue(6)：39-44,6.DOI:10.12010/j.issn.1673-5846.2026.06.007
利伐沙班单药与低分子肝素序贯利伐沙班治疗高龄老年静脉血栓栓塞症的临床疗效
Efficacy of Rivaroxaban Monotherapy Versus Sequential Use of Low-molecular-weight Heparin Followed by Rivaroxaban in the Treatment of Venous Thromboembolism in Elderly Patients
摘要
Abstract
Objective To explore the clinical efficacy of using rivaroxaban alone versus sequential use of low-molecular-weight heparin followed by rivaroxaban in the treatment of venous thromboembolism(VTE)in elderly patients.Methods A total of 160 elderly VTE patients aged over 80 years old who were admitted to Kunming Second People's Hospital from January 2021 to December 2024 were selected.They were randomly divided into the experimental group and the control group,with 80 cases in each group.The experimental group was treated with rivaroxaban alone,while the control group was treated with low molecular weight heparin followed by rivaroxaban.Both groups received continuous treatment for 12 months.The therapeutic effects,liver and kidney functions,and coagulation indicators of the two groups before and after treatment,as well as the occurrence of adverse reactions were compared.Results There was no statistically significant difference in the incidence of new or recurrent venous thrombosis,pulmonary embolism,cardiovascular and cerebrovascular events,death,and reduction or disappearance of thrombus between the two groups within 12 months of treatment(P＞0.05).After 1 month,3 months,6 months,and 12 months of treatment,the D-dimer(D-D)levels in both groups decreased,but the decrease in the control group was more significant,with a statistically significant difference(P＜0.05);after 1 month and 3 months of treatment,the activated partial thromboplastin time(APTT)in the experimental group was lower than that in the control group,with a statistically significant difference(P＜0.05);there was no statistically significant difference in platelet count(PLT),hemoglobin(Hb),prothrombin time(PT),international normalized ratio(INR),fibrinogen(FIB),glutamic-pyruvic transaminase(GPT),glutamic-oxaloacetic transaminase(GOT),and serum creatinine(SCr)between the two groups before and after treatment(P＞0.05).During the treatment period,the incidence of adverse reactions in the experimental group was 71.25%,compared with 73.75%in the control group,with no statistically significant difference(P＞0.05).The incidence of adverse reactions in the experimental group was 15.00%,and that in the control group was 25.00%.Among them,the incidence of gastrointestinal bleeding adverse reactions was 5.00%in the experimental group and 10.00%in the control group.The main adverse reactions with higher incidence in both groups were positive fecal occult blood,followed by gastrointestinal bleeding,hematuria,etc.Conclusion The clinical efficacy of rivaroxaban monotherapy is comparable to that of sequential low-molecular-weight heparin followed by rivaroxaban in the treatment of VTE in elderly patients.Rivaroxaban monotherapy significantly reduced APTT more effectively,while the sequential use of low molecular weight heparin followed by rivaroxaban significantly reduced D-D levels.Both could effectively improve the coagulation function of patients.However,rivaroxaban had higher treatment compliance,a lower incidence of bleeding-related adverse events,and a more significant safety advantage.关键词
利伐沙班/低分子肝素/高龄老年人/静脉血栓栓塞症Key words
Rivaroxaban/Low-molecular-weight heparin/Elderly/Venous thromboembolism分类
医药卫生引用本文复制引用
张琳,李海峰,杨晓佳,饶嫱,徐铭蔚,董莎莎..利伐沙班单药与低分子肝素序贯利伐沙班治疗高龄老年静脉血栓栓塞症的临床疗效[J].中国药物经济学,2026,21(6):39-44,6.基金项目
昆明市卫生科技项目(2023-13-01-016,2023-03-02-014) （2023-13-01-016,2023-03-02-014）
