目的 探討羥苯磺酸鈣聯(lián)合利伐沙班治療下肢深靜脈血栓形成后綜合征的臨床療效。方法 選取2020年8月—2024年7月晉江市醫(yī)院收治的下肢深靜脈血栓形成后綜合征患者86例，按照隨機數(shù)字法分為對照組（43例）和治療組（43例）。對照組患者口服利伐沙班片，10 mg/次，1次/d。在對照組的基礎(chǔ)上，治療組口服羥苯磺酸鈣片，500 mg/次，1次/d。兩組用藥30 d后觀察治療情況。觀察兩組臨床療效，比較治療前后兩組患者癥狀好轉(zhuǎn)時間，靜脈臨床嚴重程度評分（VCSS）和Villalta評分，凝血指標活化部分凝血活酶時間（APTT）、纖維蛋白原（FIB）和凝血酶原時間（PT），及血清炎性因子D-二聚體（D-D）、細胞間黏附分子-1(ICAM-1)、腫瘤壞死因子-α(TNF-α)和白細胞介素-6(IL-6)水平。結(jié)果 治療后，治療組總有效率（95.35%）明顯高于對照組的總有效率（79.07%,P<0.05）。治療后，治療組下肢腫脹、下肢疼痛、下肢淺靜脈擴張、下肢皮膚暗紅改善時間均明顯短于對照組（P<0.05）。治療后，兩組患者VCSS評分和Villalta評分比治療前明顯降低（P<0.05），且治療組評分明顯低于對照組（P<0.05）。治療后，兩組患者APTT、PT水平均明顯高于治療前，而FIB水平明顯降低（P<0.05），且治療組凝血指標水平明顯好于對照組（P<0.05），治療后，兩組患者D-D、ICAM-1、TNF-α、IL-6水平比治療前明顯降低（P<0.05），且治療組炎性因子水平均明顯低于對照組（P<0.05）。結(jié)論 羥苯磺酸鈣與利伐沙班協(xié)同治療能對患者的癥狀和體征起到好轉(zhuǎn)作用，并能改善凝血功能和降低機體炎性反應(yīng),能使靜脈回流情況改善。

Objective To explore the clinical efficacy of calcium dobesilate combined with rivaroxaban in treatment of lower limb deep vein thrombosis syndrome. Methods Patients（86 cases） with lower limb deep vein thrombosis syndrome in Jinjiang Hospital from August 2020 to July 2024 were divided into control（43 cases） and treatment（43 cases） group according to random number method. Patients in the control group were po administered with Rivaroxaban Tablets, 10 mg/time, once daily. Patients in the treatment group were po administered with Calcium Dobesilate Tablets, 500 mg/time, once daily. Patients in two groups were treated for 30 d. After treatment, the clinical evaluations were evaluated, the symptom relief time, VCSS and Villalta scores, the coagulation indexes APTT, PT, and FIB, and the inflammatory factors D-D, ICAM-1, TNF-α, and IL-6 in two groups before and after treatment were compared. Results After treatment, the effective rate in the treatment group（95.35%） was significantly higher than that in the control group（79.07%, P＜0.05）. After treatment, the improvement time of lower limb swelling, pain, superficial venous dilation and dark red skin in the treatment group was significantly shorter than that in the control group（P＜0.05）. After treatment, the VCSS scores and Villalta scores in two groups were significantly lower than those before treatment（P＜0.05）, and the scores in the treatment group were significantly lower than those in the control group（P＜0.05）. After treatment, the levels of APTT and PT in two groups were significantly higher than those before treatment, but the levels of FIB were significantly lower（P＜0.05）, and the levels of coagulation indicators in the treatment group were significantly better than those in the control group（P＜0.05）. After treatment, the levels of DD, ICAM-1, TNF-α, and IL-6 in two groups were significantly lower than those before treatment（P＜0.05）, and the levels of inflammatory factors in the treatment group were significantly lower than those in the control group（P＜0.05）. Conclusion The synergistic treatment of calcium dobesilate and rivaroxaban can improve the symptoms and signs, improve coagulation function and reduce the inflammatory response, and improve venous reflux.

R973

福建省自然科學(xué)基金資助項目(2023J01653)