利伐沙班治疗急性肺栓塞的疗效观察及对血管内皮功能的影响

目的 探讨利伐沙班治疗急性肺栓塞的临床疗效及对患者血管内皮功能的影响。方法 选取2015年1月—2018年1月浙江大学附属第一医院北仑分院确诊的急性肺栓塞患者50例，根据随机数字表法，将其分为对照组（华法林治疗）和观察组（利伐沙班治疗），每组25例。观察和比较两组治疗的临床疗效、治疗前后患者动脉血氧分压（PaO2）、二氧化碳分压（PaCO2）、心率（HR）变化，以及C反应蛋白（CRP）、心肌肌钙蛋白I（cTnI）D-D（D-D）、内皮素-1（ET-1）、一氧化氮NO、血管性假血友病因子（vWF）水平变化。结果 观察组治疗的总有效率高于对照组（P?<0.05）；观察组治疗后PaO2、PaCO2高于对照组，HR低于对照组（P?<0.05）；观察组治疗后CRP、cTnI、D-D、ET-1、vWF水平均低于对照组，NO水平高于对照组（P?<0.05）；观察组治疗的不良反应发生率低于对照组（P?<0.05）。结论 利伐沙班能提高急性肺栓塞治疗的临床疗效及安全性，降低血清CRP、cTnI、D-D、ET-1、vWF水平，提高NO水平，改善患者血管内皮功能。

Effect of rivaroxaban on vascular endothelial function for patients with acute pulmonary embolism

Objective To study the clinical efficacy of rivaroxaban treatment for acute pulmonary embolism and the effect of it on vascular endothelial function. Method A total of 50 patients with acute pulmonary embolism in our hospital during the period from Jan 2015 to Jan 2018 were randomized into the control group (warfarin treament) and the observation group (rivaroxaban treatment) according to random number method, 25 patients per group. The clinical efficacy of treatment, changes of arterial partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), heart rate (HR), and C reactive protein (CRP), cTnI, D-dimer (D-D), endothelin-1 (ET-1), nitric oxide (NO), vascular pseudomonia factor (vWF) in two groups were observed and compared. Results Compared with the control group, the total effective rate of treatment in the observation group was increased (P?< 0.05); Compared with the control group, the levels of PaO2 and PaCO2 were increased and HR was decreased after treatment in the observation group (P?