低剂量达比加群酯对高龄静脉血栓栓塞症患者的临床疗效

摘要

Objective To observe the effect of low-dose dabigatran etexilate on the clinical efficacy of elderly patients with venous thromboembolism (VTE). Methods Seventy-five elderly (≥ 80 years old) VTE patients admitted to Cangzhou Central Hospital from October 2016 to June 2018 were enrolled, they were treated according to the VTE guidelines, and low dose dabigatran etexilate was the anticoagulant therapy selected, 110 mg once daily for 6 months. After treatment for 6 months, the thrombus regression situation with color Doppler ultrasonography;clinical efficacy was evaluated by clinical symptoms and ultrasonographic results, the changes in platelet count (PLT), coagulation parameters [international normalized ratio (INR), activated partial thromboplastin time (APTT), fibrinogen (Fib)] before and after treatment were detected and the occurrence of adverse reactions were recorded and safety of drug was evaluated. Results There were no significant differences in PLT, INR and Fib before and after treatment [PLT (×109/L): 197.88±58.00 vs. 199.88±65.15, INR: 1.02±0.10 vs. 1.05±0.13, Fib (g/L): 2.89±0.67 vs. 2.84±0.70, all P > 0.05], the APTT after treatment was significantly prolonged compared with that before treatment (seconds:40.9±7.34 vs. 26.2±3.16), the difference being statistically significant (P < 0.05), the amount of APTT prolongation after treatment did not exceed 2 times [average (1.75±0.24) times] of the baseline value before treatment. The total effective rate of low-dose dabigatran etexilate for treatment of elderly patients with VTE for 6 months was 90.7% (68/75);no obvious adverse reactions occurred during the treatment. Conclusion Low-dose dabigatran etexilate for treatment of elderly patients with VTE is safe and effective without any obvious adverse reactions, and is worthy to be promoted for clinical use.%目的 观察低剂量达比加群酯对高龄静脉血栓栓塞症(VTE)患者临床疗效的影响.方法 选择沧州市中心医院2016年10月至2018年6月收治的75例高龄(≥80岁)VTE患者,按照VTE指南,采用低剂量达比加群酯110 mg进行抗凝治疗,每日1次,疗程6个月.用彩色超声检查治疗6个月后患者血栓消退情况;采用临床症状和超声结果评价临床疗效.疗程前后检测血小板计数(PLT)、凝血指标〔国际标准化比值(INR)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)〕的变化,记录不良反应发生情况以评价药物安全性.结果 患者治疗前后PLT、INR及Fib比较差异均无统计学意义〔PLT(×109/L):197.88±58.00比199.88±65.15,INR :1.02±0.10比1.05±0.13,Fib(g/L):2.89±0.67比2.84±0.70,均P＞0.05〕;治疗后APTT较治疗前明显延长(s :40.9±7.34比26.2±3.16,P＜0.05),但75例患者的延长量均未超过治疗前基础值的2倍〔平均(1.75±0.24)倍〕.高龄VTE患者服用低剂量达比加群酯6个月的总有效率为90.7%(68/75);治疗过程中无明显不良反应发生.结论 对于高龄VTE患者,低剂量达比加群酯安全有效,无显著不良反应,值得在临床上推广使用.