Efficacy and safety of low-dose anticoagulant therapy for acute isolated distal deep vein thrombosis
焦乐 1杨涛 1王丽萍
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作者信息
1. 山西白求恩医院 山西医学科学院 同济山西医院血管外科，太原 030032
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摘要
目的 评估小剂量新型口服抗凝药物利伐沙班在急性孤立性远端深静脉血栓形成（IDDVT）治疗中的疗效和安全性。 方法 回顾性分析山西白求恩医院血管外科2021年1月至10月诊治的113例急性IDDVT患者的临床资料。通过彩色多普勒超声检查诊断为DVT，并完善了血常规、肝肾功能、凝血指标等常规检查，确诊后均接受利伐沙班治疗。根据利伐沙班服用剂量不同，分为小剂量抗凝治疗组（54例，小剂量组）和标准剂量抗凝治疗组（59例，标准剂量组）。比较两组治疗后血栓消退、血栓近端进展率、全因死亡率以及相关的抗凝出血并发症等。 结果 χ 在近端深静脉血栓（PDVT）、肺栓塞（PE）和PDVT/PE的发生率方面，小剂量组和标准剂量组之间差异无统计学意义（均P>0.05）。在血栓消退方面，小剂量组略低于标准剂量组，但两组差异无统计学意义（22.2%比27.1%，P=0.211）。小剂量组非大出血事件的发生率较标准剂量组低，两组差异有统计学意义（1.9%比15.3%，2=6.278，P=0.032）；小剂量抗凝组大出血事件发生率较标准剂量组低，但两组差异无统计学意义（0比1.7%，P=0.485）。 结论 小剂量抗凝治疗急性IDDVT与标准剂量抗凝治疗的疗效相当，但出血事件更少，安全性更高。 Objective To evaluate the efficacy and safety of low-dose novel oral anticoagulant rivaroxaban for the treatment of acute isolated distal deep vein thrombosis (IDDVT). Methods A retrospective analysis was conducted on clinical records of 113 patients diagnosed with acute IDDVT from January to October 2021 at the Department of Vascular Surgery of Shanxi Bethune Hospital. The patients underwent color Doppler ultrasound for DVT diagnosis as well as routine blood tests, liver and kidney function tests, and tests of coagulation indicators. After the diagnosis was confirmed, all patients received treatment with rivaroxaban. The patients were divided into two groups according to doses: a low-dose anticoagulant group (54 cases) and a standard-dose anticoagulant group (59 cases). Thrombus regression, progression rate of proximal thrombus, all-cause mortality, and anticoagulant-related bleeding complications were evaluated between the two groups after treatment. Results χ There was no significant difference in the incidence of proximal deep venous thrombosis (PDVT),pulmonary embolism (PE), and PDVT/PE between the low-dose anticoagulant group and the standard-dose anticoagulant group (all P>0.05). Regarding thrombus regression, there was no statistically significant difference between the two groups, but the standard-dose group had slightly better performance than the low-dose group (27.1%vs. 22.2%,P=0.211). However, the incidence of non-major bleeding events in the low-dose anticoagulant group was lower than that in the standard-dose group, demonstrating a statistically significant difference between the two groups (1.9% vs. 15.3%,2=6.278，P=0.032). No statistically significant difference in the incidence of major bleeding events was found between the two groups (P=0.485). Conclusion Low-dose anticoagulant therapy for acute IDDVT has comparable efficacy to standard-dose anticoagulant therapy, but with fewer bleeding events and higher safety.
Abstract
Objective To evaluate the efficacy and safety of low-dose novel oral anticoagulant rivaroxaban for the treatment of acute isolated distal deep vein thrombosis (IDDVT). Methods A retrospective analysis was conducted on clinical records of 113 patients diagnosed with acute IDDVT from January to October 2021 at the Department of Vascular Surgery of Shanxi Bethune Hospital. The patients underwent color Doppler ultrasound for DVT diagnosis as well as routine blood tests, liver and kidney function tests, and tests of coagulation indicators. After the diagnosis was confirmed, all patients received treatment with rivaroxaban. The patients were divided into two groups according to doses: a low-dose anticoagulant group (54 cases) and a standard-dose anticoagulant group (59 cases). Thrombus regression, progression rate of proximal thrombus, all-cause mortality, and anticoagulant-related bleeding complications were evaluated between the two groups after treatment. Results χ There was no significant difference in the incidence of proximal deep venous thrombosis (PDVT),pulmonary embolism (PE), and PDVT/PE between the low-dose anticoagulant group and the standard-dose anticoagulant group (all P>0.05). Regarding thrombus regression, there was no statistically significant difference between the two groups, but the standard-dose group had slightly better performance than the low-dose group (27.1%vs. 22.2%,P=0.211). However, the incidence of non-major bleeding events in the low-dose anticoagulant group was lower than that in the standard-dose group, demonstrating a statistically significant difference between the two groups (1.9% vs. 15.3%,2=6.278，P=0.032). No statistically significant difference in the incidence of major bleeding events was found between the two groups (P=0.485). Conclusion Low-dose anticoagulant therapy for acute IDDVT has comparable efficacy to standard-dose anticoagulant therapy, but with fewer bleeding events and higher safety.
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