Effect of rivaroxaban combined with ateplase on acute pulmonary embolism and its influence on inflammatory factors and coagulation function / 中国医师进修杂志

ABSTRACT

Objective:To investigate the therapeutic effect of rivaroxaban combined with ateplase on patients with acute pulmonary embolism and its influence on inflammatory factors and coagulation function.Methods:One hundred and two patients with acute pulmonary embolism admitted to the First People′s Hospital of Linping District from March 2016 to March 2020 were divided into observation group (51 cases) and control group (51 cases) by random number table.Methods:The control group was treated with ateplase, and the observation group was treated with rivaroxaban on the basis of the control group. The course of treatment in both groups was 10 d. The effective and the changes of arterial partial pressure of oxygen (PaO 2), partial pressure of carbon dioxide in artery (PaCO 2), heart rate(HR), inflammatory factors and coagulation index were compared before and after treatment between the two groups. Results:The total effective rate after treatment in the observation group was higher than that in the control group 90.20%(46/51) vs. 68.63%(35/51), the difference was statistically significant ( χ2 = 7.256, P<0.05). The level of PaO 2 after treatment in the observation group was higher than that in the control group, the levels of PaCO 2 and HR after treatment in the observation group were lower than those in the control group (82.91 ± 4.35) mmHg (1 mmHg = 0.133 kPa) vs. (73.35 ± 2.97) mmHg, (34.21 ± 2.89) mmHg vs. (39.98 ± 3.25) mmHg, (76.83 ± 3.76) beats/min vs. (84.20 ± 3.15) beats/min, the differences were statistically significant ( t = 12.96, 9.48, 9.17, P<0.05). The levels of interleukin (IL)- 1β, IL-6 and tumor necrosis factor-α after treatment in the observation group were lower than those in the control group (0.62 ± 0.20) μg/L vs. (1.08 ± 0.23) μg/L, (15.42 ± 2.53) μg/L vs.(20.93 ± 2.78) μg/L, (0.49 ± 0.16) μg/L vs. (0.78 ± 0.12) μg/L, the differences were statistically significant ( t = 10.78, 10.47, 10.36, P<0.05). The levels of fibrinogen, D-Dimer after treatment in the observation group were lower than those in the control group (2.78 ± 0.61) g/L vs. (3.53 ± 0.54) g/L, (1.18 ± 0.23) mg/L vs. (1.69 ± 0.28) mg/L; but the levels of prothrombin time, activate part plasma prothrombin time after treatment in the observation group were longer than those in the control group (15.85 ± 1.48) s vs. (13.04 ± 1.27) s, (40.79 ± 2.34) s vs. (37.46 ± 2.98)s, the differences were statistically significant ( t = 6.58, 10.05, 10.29, 6.28, P<0.05). Conclusions:Rivaroxaban combined with ateplase is effective in the treatment of acute pulmonary embolism, and it can reduce inflammatory reaction and improve coagulation function.