利伐沙班治疗静脉血栓效果怎样

(Rivaroxaban) is a direct oral anticoagulant that can act on factor

In order to explore the effectiveness and safety of rivaroxaban in the treatment of thrombotic diseases in the elderly, a domestic study retrospectively selected 301 elderly inpatients taking rivaroxaban, aged 60 to 102 years old (86.5±8.4) years old. An anticoagulation plan was formulated based on comprehensive assessment of patient indications, creatinine clearance, ischemia and bleeding risks, and was divided into rivaroxaban 2.5~5.0 mg/d group (72 cases), 10.0 mg/d group (205 cases), and 15.0~20.0 mg/d group (24 cases). The liver and kidney function and coagulation indicators before and after the application of rivaroxaban were detected, and fatal bleeding, cardiac death, all-cause death, non-fatal bleeding and ischemic events during the observation period were recorded.

The results showed that the dose of rivaroxaban in the included patients was (9.3±3.0) mg/d, and the minimum dose was 2.5 mg/d. The follow-up period was (14.9±13.9) months, and the longest follow-up period was 48 months. One case of intracranial hemorrhage, 3 cases of cardiac death (1.0%), and 20 cases of all-cause death (6.6%) occurred after rivaroxaban treatment. The cumulative incidence rate was 25.2%, of which 55.0% (11 cases) died due to pneumonia and multiple organ failure; there were 40 cases (13.3%) of non-fatal bleeding events, with a cumulative incidence rate of 42.4%; 7 cases (2.3%) of ischemic events, with a cumulative incidence rate of 16.0%, including 2 cases of non-fatal myocardial infarction, 3 cases of cerebral infarction, and 2 cases of lower extremity venous thromboembolism. Compared with before medication, the prothrombin time in coagulation indicators was prolonged, fibrinogen (FIB) increased, and D-dimer decreased (P<0.05).

It can be concluded that compared with previous literature reports, low-dose rivaroxaban anticoagulant therapy is safe and effective in elderly patients with thrombotic diseases, but it is necessary to comprehensively assess the patient's risk of bleeding and ischemia, select an appropriate dose (i.e., Xarelto), and individualize medication.

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