發(fā)布時(shí)間：2019-06-04 04:07

【摘要】：目的:探討低分子肝素鈣和利伐沙班聯(lián)合阿托伐他汀對(duì)急性肺栓塞患者相關(guān)指標(biāo)的影響。方法:回顧性分析72例急性肺栓塞患者資料,根據(jù)治療方案的不同分為A組(21例)、B組(26例)和C組(25例)。A組患者入院后立即肌內(nèi)注射低分子肝素鈣注射液2 d后加用華法林鈉片,7 d后停用低分子肝素鈣注射液,繼續(xù)服用華法林3~6個(gè)月。B組患者給予低分子肝素鈣注射液(用法用量同A組),2 d后加用利伐沙班片7 d后停用低分子肝素鈣注射液,繼續(xù)服用利伐沙班3~6個(gè)月。C組患者在B組治療的基礎(chǔ)上給予阿托伐他汀鈣片,持續(xù)3~6個(gè)月。觀察3組患者呼吸困難、胸痛、發(fā)紺消失時(shí)間,治療前后心率(HR)、動(dòng)脈血氧分壓[pa(O2)]、動(dòng)脈血二氧化碳分壓[pa(CO2)]、C反應(yīng)蛋白(CRP)、D-二聚體(D-D)、腫瘤壞死因子α(TNF-α)、白細(xì)胞介素1(IL-1)、IL-6、內(nèi)皮素1(ET-1)、一氧化氮(NO)水平,臨床終點(diǎn)事件發(fā)生情況和不良反應(yīng)發(fā)生情況。結(jié)果:患者呼吸困難、胸痛、發(fā)紺消失時(shí)間A組B組C組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。治療前,3組患者HR、pa(O2)、pa(CO2)、CRP、IL-1、IL-6、TNF-α、DD、ET-1、NO水平比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。治療后,3組患者HR均顯著低于同組治療前,且A組B組C組;3組患者pa(O2)、pa(CO2)均顯著高于同組治療前,且A組B組C組,組間比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后,3組患者CRP、IL-1、IL-6、TNF-α、D-D水平均顯著低于同組治療前,且C組A、B組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);但A、B組比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。治療后,3組患者ET-1水平均顯著低于同組治療前,且C組B組A組;3組患者NO水平均顯著高于同組治療前,且C組B組A組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。C組患者臨床終點(diǎn)事件發(fā)生率顯著低于A組,B組患者不良反應(yīng)發(fā)生率顯著低于A組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 :低分子肝素鈣和利伐沙班聯(lián)合阿托伐他汀可顯著改善急性肺栓塞患者的臨床癥狀、血?dú)庵笜?biāo),減輕血管內(nèi)皮受損程度,降低細(xì)胞因子水平,改善預(yù)后,且未增加不良反應(yīng)的發(fā)生。
[Abstract]:Objective: to investigate the effects of low molecular weight heparin calcium (LMWH) and rivashaban combined with Atto statins on the related indexes of patients with acute pulmonary embolism. Methods: the data of 72 patients with acute pulmonary embolism were analyzed retrospectively. according to the different treatment schemes, they were divided into group A (21 cases). Group B (26 cases) and group C (25 patients in). A group) were treated with low molecular weight heparin calcium injection 2 days after admission and low molecular weight heparin calcium injection 7 days later. Patients in group B were given low molecular weight heparin calcium injection (the same dosage as group A), and 2 days later, rivasaban tablets were added for 7 days and then low molecular weight heparin calcium injection was stopped. Patients in group C were given Atto Vastatin calcium tablets on the basis of treatment in group B for 3 to 6 months. To observe the disappearance time of dyspnea, chest pain and cyanosis in the three groups, heart rate (HR), arterial partial pressure of oxygen [pa (O2)], arterial partial pressure of carbon dioxide [pa (CO2)] and C-reactive protein (CRP), before and after treatment. D-dimer (D 鈮，

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