利伐沙班联合阿替普酶治疗急性肺栓塞对患者凝血功能及GRP78 GRP94表达的影响

doi:10.3969/j.issn.1006-6233.2024.02.031

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Abstract Objective: To observe the effects of rivaroxaban combined with alteplase on coagulation function and the expression of glucose regulatory protein 78 (GRP78) and glucose regulatory protein 94 (GRP94) in patients with acute pulmonary embolism. Methods: A total of 104 patients with acute pulmonary embolism admitted to our hospital from January 2021 to December 2022 were selected as subjects and divided into two groups by simple random method. All patients were given absolute bed rest, analgesia, anti-infection, oxygen inhalation and other conventional treatment, conventional group (n=52) plus alteplase treatment, combined group (n=52) plus rivaroxaban plus alteplase treatment. The incidence of bleeding events in the two groups was analyzed. The differences of coagulation function, thrombus elasmogram, GRP78, GRP94, pulmonary artery pressure and blood gas indexes between the two groups were detected. Results: The activated partial thromboplastin time (APTT), prothrombin time (PT) and α Angle and reaction time in the thromboxelasticity chart of the two groups were higher after treatment than before treatment, and the difference of R and α Angle in the APTT, PT and thromboxelasticity chart before and after treatment in the combined group was greater than that in the conventional group (P<0.05). Fibrinogen (Fib) and D-dimer (D-D) in the two groups were lower after treatment than before treatment, and the difference of Fib and D-D in the combined group was greater than that in the conventional group (P<0.05). There was no significant difference in coagulation time (K) between the two groups before and after treatment (P>0.05). GRP78 and GRP94 in the two groups were lower after treatment than before treatment, and the difference of GRP78 and GRP94 before and after treatment in the combined group was greater than that in the conventional group (P<0.05). The partial pressure of arterial oxygen (PaO₂) in the two groups was higher after treatment than before treatment, and the difference of PaO₂ in the combined group was greater than that in the conventional group (P<0.05). The partial blood pressure of carbon dioxide (PaCO₂) of the two groups was lower after treatment than before treatment, and the difference of PaCO₂ before and after treatment in the combined group was greater than that in the conventional group (P<0.05). There was no significant difference in the incidence of bleeding events between the two groups (P>0.05). Conclusion: Rivaroxaban combined with alteplase in the treatment of acute pulmonary embolism can improve the coagulation function, reduce the expression of GRP78 and GRP94, and increase the blood gas index.

Key words： Acute pulmonary embolism Rivaroxaban Alteplase Coagulation function Glucose-regulatory protein

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2024.02.031 OR http://www.hbyxzzs.cn/EN/Y2024/V30/I2/330

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