Effects of Low Molecular Weight Heparin Calcium and Rivaroxaban Combined with Atorvastatin on Relat-ed Indexes in Patients with Acute Pulmonary Embolism
	    		
		   		
		   			
		   		
	    	
    	 
    	10.6039/j.issn.1001-0408.2017.21.17
   		
        
        	
        		- VernacularTitle:低分子肝素钙和利伐沙班联合阿托伐他汀对急性肺栓塞患者相关指标的影响
 
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Kun XU
			        		
			        		;
		        		
		        		
		        		
			        		Hongqing ZHAO
			        		
			        		;
		        		
		        		
		        		
			        		Jinping FENG
			        		
			        		;
		        		
		        		
		        		
			        		Xiangyun ZHU
			        		
			        		;
		        		
		        		
		        		
			        		Shuguang HAN
			        		
			        		;
		        		
		        		
		        		
			        		Xun WANG
			        		
			        		
		        		
		        		
		        		
		        		
		        		
			        		
			        		
		        		
	        		
        		 
        	
        	
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		Acute pulmonary embolism;
			        		
			        		
			        		
				        		Low molecular weight heparin calcium;
			        		
			        		
			        		
				        		Rivaroxaban;
			        		
			        		
			        		
				        		Atorvastatin;
			        		
			        		
			        		
				        		Safety
			        		
			        		
	        			
        			
        		
 
        	
            
            
            	- From:
	            		
	            			China Pharmacy
	            		
	            		 2017;28(21):2940-2943
	            	
            	
 
            
            
            	- CountryChina
 
            
            
            	- Language:Chinese
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	OBJECTIVE:To investigate the effects of low molecular weight heparin calcium and rivaroxaban combined with atorvastatin on related indexes in patients with acute pulmonary embolism(APE). METHODS:The data of 72 APE patients were analyzed retrospectively. According to treatment plan,the patients were divided into group A(21 cases),group B(26 cases)and group C(25 cases). Group A was treated with intramuscular injection of Low molecular heparin calcium injection immediately after admission;2 days later,they were given Warfarin sodium tablets;7 days later,Low molecular heparin calcium injection was stopped while warfarin was still administrated,lasting for 3-6 months. Group B was given Low molecular heparin injection(same usage and dose as group A);2 days later,they were additionally treated with Rivaroxaban tablets;7 days later,Low molecular heparin calcium injection was stopped while rivaroxaban was still administrated,lasting for 3-6 months. Based on the treatment in group B,group C was treated with Atorvastatin calcium tablets 20 mg orally,once a day in the evening,lasting for 3-6 months. The time of dyspnea,chest pain and cyanosis disappearance were observed in 3 groups as well as the levels of HR,pa(O2),pa(CO2), CRP,D-dimer,TNF-α,IL-1,IL-6,ET-1 and NO before and after treatment. The occurrence of clinical outcome events and ADR were also observed. RESULTS:The time of dyspnea,chest pain and cyanosis disappearance in group A were longer than group B, and the group B was longer than the group A,with statistical significance(P<0.05). Before treatment,there was no statistical sig-nificance in the levels of HR,pa(O2),pa(CO2),CRP,IL-1,IL-6,TNF-α,D-D,ET-1 and NO among 3 groups(P>0.05). After treatment ,HR of 3 groups were all lower than before ,and they showed group Agroup B>group C,with statistical signif-icance(P<0.05). After treatment,CRP,IL-1,IL-6,TNF-α and D-D levels in 3 groups were significantly lower than before,and they showed group C>group A and group B,with statistical significance (P<0.05);but there was no statistical significance be-tween group A and B(P>0.05). ET-1 levels in 3 groups were significantly lower than before,and the levels showed group group group B>group A,with statistical significance (P<0.05). The incidence of clinical outcome events in group A was significantly higher than group C, the incidence of ADR in group B was significantly lower than that group A,with statistical significance(P<0.05). CONCLUSIONS:Low molecular weight heparin calcium and rivaroxaban combined with atorvastatin can significantly im-prove clinical symptoms and blood gas indexes,relieve vascular endothelial damage,reduce the levels of inflammatory cytokines and improve the prognosis of patients with APE,without increasing the incidence of ADR.