利伐沙班与低分子肝素对老年AECOPD患者症状缓解、血气分析指标及凝血功能的影响

目的:探讨利伐沙班与低分子肝素对老年慢性阻塞性肺疾病急性加重期(AECOPD)患者症状缓解、血气分析指标及凝血功能的影响。方法:选取2016年8月~2019年11月期间我院收治的老年AECOPD患者72例,按照抽签法分为对照组(n=36,低分子肝素治疗)和研究组(n=36,利伐沙班治疗),对比两组疗效、症状缓解、血气分析指标及凝血功能,记录治疗期间不良反应情况。结果:研究组治疗10d后总有效率较对照组高(P<0.05)。两组咳嗽、咳痰、发热、呼吸困难症状缓解时间对比差异无统计学意义(P>0.05)。治疗10d后两组氧分压(PaO₂)、氧饱和度(SaO₂)升高,二氧化碳分压(PaCO₂)降低(P<0.05),研究组治疗10d后PaO₂、SaO₂较对照组高,PaCO₂低于对照组(P<0.05)。治疗10d后两组纤维蛋白原(Fib)升高,D-二聚体(D-D)、活化部分凝血活酶时间(APTT)、血浆凝血酶原时间(PT)、凝血酶时间(TT)均降低(P<0.05),治疗10d后研究组D-D低于对照组(P<0.05),治疗10d后两组Fib、APTT、TT、PT组间比较无差异(P>0.05)。两组不良反应发生率比较无差异(P>0.05)。结论:老年AECOPD患者采用利伐沙班与低分子肝素治疗,均可改善患者临床症状且安全性较好,但采用利伐沙班治疗者疗效更好,血气分析指标及凝血功能改善更佳。

Effects of Rivaroxaban and Low Molecular Weight Heparin on Symptom Relief, Blood Gas Analysis Indexes and Coagulation Function in Elderly Patients with AECOPD

ABSTRACT Objective: To investigate the effects of rivaroxaban and low molecular weight heparin on the symptom relief, blood gas analysis indexes and coagulation function in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: A total of 72 elderly patients with AECOPD admitted to our hospital from August 2016 to November 2019 were selected, and were randomly divided into control group (n=36, low molecular weight heparin treatment) and study group (n=36, rivaroxaban treatment) by lottery. The efficacy, symptom relief, blood gas analysis index and coagulation function of the two groups were compared, and adverse reactions during the treatment were recorded. Results: The total effective rate of the study group 10 days after treatment was higher than the control group (P<0.05). There were no significant differences in the relief time of cough, sputum, fever and dyspnea between the two groups (P>0.05). 10 days after treatment, the oxygen partial pressure (PaO₂), oxygen saturation (SaO₂) of the two groups increased, while the partial pressure of carbon dioxide (PaCO₂) of the two groups decreased (P<0.05). 10 days after treatment, PaO₂ and SaO₂ of the study group were higher than the control group, while PaCO₂ was lower than those of the control group (P<0.05). 10 days after treatment, fibrinogen (Fib) of the two groups increased, D-Dimer (D-D), activated partial thromboplastin time (APTT), plasma prothrombin time (PT) and thrombin time (TT) decreased (P<0.05). 10 days after treatment, D-D of the study group was lower than the control group (P<0.05). There were no significant differences between Fib, APTT, TT and PT of the two groups (P>0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Elderly patients with AECOPD treated with rivaroxaban and low molecular weight heparin can improved their clinical symptoms and showed better safety, but those treated with rivaroxaban had better efficacy, and better improvement in blood gas analysis indicators and coagulation function.