利伐沙班对急性肺栓塞患者氧化应激及细胞因子的影响

Effect of Rivaroxaban on Oxidative Stress and Cytokine in Patients with Acute Pulmonary Embolism

摘要: 目的：探讨利伐沙班对急性肺栓塞患者氧化应激及细胞因子的影响。方法：选取2020年1月到2021年8月收治的100例肺栓塞患者作为研究对象。随机分为对照组(n = 50)和观察组(n = 50)。对照组患者皮下注射低分子肝素钙联合口服华法林治疗，观察组患者采用皮下注射低分子肝素钙联合口服利伐沙班治疗。比较两组患者治疗4周后临床疗效，C反应蛋白(CRP)、白细胞介素-10 (IL-10)、肿瘤坏死因子-α (TNF-α)、丙二醛(MDA)及超氧化物歧化酶(SOD)水平。记录两组患者治疗期间不良反应发生情况。结果：治疗后观察组总有效率高于对照组。两组肺栓塞患者血清SOD水平治疗后较治疗前均增高，MDA水平均下降，差异均有统计学意义(P < 0.05)。但治疗后，两组间SOD及MDA水平比较，差异均无统计学意义(P > 0.05)。治疗后两组肺栓塞患者血清IL-10、CRP、TNF-α水平较治疗前均下降，且观察组患者血清IL-10、CRP、TNF-α水平低于对照组，差异均有统计学意义(P < 0.05)。两组不良反应发生率比较，差异无统计学意义(P > 0.05)。结论：利伐沙班治疗急性肺栓塞患者疗效确切，可有效抑制炎症反应，安全性较好。但利伐沙班和华法林在抗氧化应激方面没有显著差异。

Abstract: Objective: To observe the effect of rivaroxaban on oxidative stress and cytokine in patients with acute pulmonary embolism. Methods: A total of 100 patients with acute pulmonary embolism were selected from January 2020 to August 2021, and they were randomly divided into control group and observation group, each of 50 cases. Patients in control group received low molecular-weight heparin combined with warfarin, while patients in observation group received low-molecular-weight heparin combined with rivaroxaban. The total effective rate, C reactive protein (CRP), interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α), malondialdehyde (MDA) and oxide dismutase (SOD) in serum levels before and after four weeks of treatment were compared between the two groups. The incidence of adverse reactions was observed during the treatment. Results: Clinical effect in observation group was statistically significantly better than that in control group (P < 0.05). After treatment, the level of serum SOD in patients with pulmonary embolism in the two groups increased and the level of MDA decreased compared with that before treatment (P < 0.05). However, there was no significant difference in the levels of SOD and MDA between the two groups after treatment (P > 0.05). After treatment, the levels of serum IL-10, CRP and TNF-α in patients with pulmonary embolism in the two groups decreased, and the levels of serum IL-10, CRP and TNF-α in the observation group were lower than those in the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion: Rivaroxaban is effective in the treatment of acute pulmonary embolism, which can effectively inhibit inflammatory reaction, and safety is relatively higher. There is no significant difference in antioxidant stress between rivaroxaban and warfarin.