[直接口服抗凝剂利伐沙班和低分子量肝素治疗肿瘤患者静脉血栓栓塞疗效比较分析]。

L Dong, Y D Hu, W F Xiong, J Y Du, C W Li, C L Xie, J Z Lyu, A Cui, D B Zhou, S H Li, N Zhu, X J Zhang, S Q Li
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引用次数: 0

摘要

目的探讨直接口服抗凝剂利伐沙班和低分子量肝素(LMWH)治疗肿瘤患者静脉血栓栓塞症(VTE)的有效性和安全性。研究方法对2020年12月至2022年9月期间上海肺血栓栓塞症数据库中确诊的296例肿瘤相关VTE患者进行回顾性分析。根据抗凝药物处方对患者进行分组。13个基线变量[年龄、性别、吸烟史、身体状况(PS)评分、肿瘤类型、肿瘤分期、肿瘤治疗方法、血红蛋白、血小板、D-二聚体、肌酐、丙氨酸氨基转移酶和VTE部位]进行了匹配。匹配后,100 例患者被分配到利伐沙班组,其中男性 64 例,女性 36 例,年龄[M(Q1,Q3)]70(62,74)岁;LMWH 组 100 例,其中男性 69 例,女性 31 例,年龄 68(60,73)岁。采用 Kaplan-Meier 法绘制生存曲线。采用对数秩检验分析利伐沙班组与 LMWH 组在 6 个月累积 VTE 复发率、临床显著出血率和全因死亡率方面的差异。结果利伐沙班组与 LMWH 组在 6 个月累积 VTE 复发率方面无统计学差异[13.5%(95%CI:6.4%-20.1%) vs 7.5%(95%CI:2.0%-12.7%),P=0.171]、出血发生率[9.2%(95%CI:3.3%-14.8%) vs 6.2%(95%CI:1.3%-10.9%),P=0.438]和全因死亡率[8.0%(95%CI:2.5%-13.2%) vs 10.0%(95%CI:3.9%-15.7%),P=0.602]。结论利伐沙班和 LMWH 对肿瘤 VTE 患者的抗凝疗效和安全性相当。
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[Comparative analysis of the efficacy of direct oral anticoagulant rivaroxaban and low molecular weight heparin in the treatment of tumor patients with venous thromboembolism].

Objective: To explore the effectiveness and safety of direct oral anticoagulant rivaroxaban and low molecular weight heparin (LMWH) in the treatment of tumor patients with venous thromboembolism (VTE). Methods: A retrospective analysis was conducted on 296 patients diagnosed with tumor associated VTE in the Shanghai Pulmonary Thromboembolism Database from December 2020 to September 2022. Patients were grouped according to the prescription of anticoagulant drugs. Thirteen baseline variables [age, gender, smoking history, physical state (PS) score, tumor type, tumor stage, tumor treatment method, hemoglobin, platelets, D-dimer, creatinine, alanine aminotransferase, and VTE site] were matched. After matching, 100 cases were assigned to rivaroxaban group, including 64 males and 36 females, aged [M (Q1, Q3)] 70 (62,74) years old; There were 100 cases in the LMWH group, including 69 males and 31 females, aged 68 (60,73) years old. Kaplan-Meier method was used to plot survival curves. The differences between the rivaroxaban group and LMWH group in 6-month cumulative VTE recurrence rate, clinically significant bleeding rate, and all-cause mortality rate were analysed using log-rank test. Results: There were no statistically significant differences between the rivaroxaban group and the LMWH group in the 6-month cumulative VTE recurrence rate [13.5% (95%CI: 6.4%-20.1%) vs 7.5% (95%CI: 2.0%-12.7%), P=0.171], bleeding incidence rate [9.2% (95%CI: 3.3%-14.8%) vs 6.2% (95%CI: 1.3%-10.9%), P=0.438] and all-cause mortality rate [8.0% (95%CI: 2.5%-13.2%) vs 10.0% (95%CI: 3.9%-15.7%), P=0.602]. Conclusion: The anticoagulant efficacy and safety of rivaroxaban and LMWH are comparable in tumor patients with VTE.

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来源期刊
Zhonghua yi xue za zhi
Zhonghua yi xue za zhi Medicine-Medicine (all)
CiteScore
0.80
自引率
0.00%
发文量
400
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