山东半岛急性下肢深静脉血栓形成人群利伐沙班抗凝的有效剂量分析

发布时间：2018-03-14 10:35

本文选题：利伐沙班　切入点：华法林　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：下肢深静脉血栓形成(Lower extremity deep venous thrombosis LEDVT),是血液在下肢深静脉血管内发生异常凝集形成血栓。首选治疗是抗凝治疗,预防血栓继续进展,降低血栓脱落风险。华法林作为经典的抗凝药物,抗凝效果好,但需要定期监测凝血酶指标。其出血风险及服用不方便导致了部分患者不能获益。而新型口服抗凝药利伐沙班(Rivaroxaban)是直接针对凝血因子Xa的一种抑制剂,减少凝血酶原复合物中的Xa因子而起到抗凝作用。不需要监测凝血,出血几率低,服用方便。目前的说明书主要针对欧美深静脉血栓人群,本实验通过观察患者临床疗效、患肢周径、凝血指标的变化、治疗后血栓及血管再通状况的变化,探索山东半岛急性下肢深静脉血栓形成人群服用利伐沙班的有效剂量。方法:将烟台毓璜顶医院、山东省千佛山医院、潍坊市人民医院、威海市立医院、临沂市第二人民医院等多家中心2015-12至2016-12符合纳入标准的急性下肢深静脉血栓患者共308例。随机分成A组(10mg组)和B组(15mg组)。A组患者入院后给予利伐沙班10mg p.o bid。B组患者入院后给予利伐沙班15mg p.o bid。两组其他治疗相同。通过观察患者临床疗效、患肢周径、凝血指标的变化,同时观察两组患者有无不良反应及并发症。结果:本研究证明A组患者与B组患者进过治疗后均明显好转,肢体周径差2cm,凝血指标差异均无统计学意义。结论:对于胶东半岛急性下肢深静脉血栓形成的患者可给予利伐沙班10mg p.o bid来进行抗凝治疗,既安全有效又减轻经济负担。
[Abstract]:Lower extremity deep venous thrombosis LEVT is an abnormal coagulation of blood in the deep vein of lower extremity. The first choice is anticoagulant therapy to prevent thrombus progression. Reduce the risk of thrombus loss. Warfarin, as a classic anticoagulant, has a good anticoagulant effect. But there is a need for regular monitoring of thrombin markers. The risk of bleeding and inconvenient use of thrombin may not benefit some patients. Rivaroxaban, a new oral anticoagulant, is a direct inhibitor of the coagulation factor Xa. Reducing the Xa factor in prothrombin complex plays an anticoagulant effect. There is no need to monitor coagulation, the bleeding probability is low, and it is convenient to take it. The present instructions are mainly aimed at the people with deep venous thrombosis in Europe and the United States. In this experiment, we observed the clinical efficacy of the patients. The changes of peripheral diameter of affected limbs, blood coagulation index, thrombus and vascular recanalization after treatment were studied in order to explore the effective dosage of rivastaban in acute lower extremity deep vein thrombosis in Shandong Peninsula. Shandong Qianfoshan Hospital, Weifang people's Hospital, Weihai Municipal Hospital, A total of 308 patients with acute deep venous thrombosis of lower extremity met the inclusion criteria from 2015-12 to 2016-12 in Linyi second people's Hospital and other centers. They were randomly divided into two groups: group A (10 mg) and group B (15 mg). After admission, the patient was given Rivashaban 15 mg p.o bid. the other two groups were treated the same. By observing the clinical efficacy of the patients, The changes of peripheral diameter and coagulation index of the affected limbs, and the adverse reactions and complications of the two groups were observed. Results: this study proved that the patients in group A and group B were obviously improved after treatment. Conclusion: patients with acute lower extremity deep vein thrombosis in Jiaodong Peninsula can be treated with 10 mg bid of Levashaban for anticoagulant therapy, which is safe, effective and economical.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R543.6

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