Clinical Observation On The Effect Of Argatroban In The Treatment Of Lower Extremity Deep Venous Thrombosis

Objective:Deep venous thrombosis (DVT) is a common peripheral venous vascular disease, is in a deep vein blood clotting caused by abnormal venous disorders, almost occurs in the lower limbs; thrombosis can cause pulmonary embolism (PE), both collectively known as venous thromboembolism (venous thromboembolism, VTE). Serious PE can cause patients died, most of DVT patients may develop PTS, seriously affecting the quality of life of patients; and the incidence of DVT is higher day by day.The treatment of DVT is always a Clinical treatment of difficulty. And the common treatment methods include:operation thrombectomy, anticoagulation, thrombolysis, mechanical ablation, angioplasty and so on. Anticoagulation therapy is the treatment of foundation, current anticoagulant therapy drugs are widely used heparin or low molecular weight heparin.But its role has many limitations,and a large number of applications of heparin,low molecular weight heparin in clinical can cause severe side effects,and heparin induced thrombocytopenia and thrombosis syndrome, HTT/HITTS, are Gradually recognized.Based on the above disadvantages of heparin, scholars continue to explore new anticoagulant drugs. Argatroban, larginine derived from, is chemical synthesis of the low molecular direct inhibition of thrombin preparations, directly related to the catalytic site of thrombin binding (including serine-histidine-arginine structure), inactivated thrombin. Argatroban is currently used in a variety of arterial disease, the effect is safe and effective; as a direct thrombin inhibitor, does not need to play a role by antithrombin Ⅲ. Whether it is good or not to applied to vein thrombosis diseases, play better therapeutic effects, pending further clinical studies. In this study, clinical efficacy in patients with biochemical tests, complications, and thrombotic vascular ultrasonography changes observed explore the clinical application value argatroban treatment of deep venous thrombosis, whether safe and effective.Methods:We collected a total of80cases of patients with lower extremity DVT, which are cured in our hospital from January to december of2013,and met the inclusion criteria. They were randomly divided into two groups, experimental(40cases) and control groups(40cases). Experimental group:argatroban10mg added to100ml of0.9%saline intravenous infusion within2hours twice a day, ten days as a course of treatment.; Control group:Low molecular heparin0.4ml subcutaneous injection twice a day, ten days is a course of treatment. Meanwhile the2groups:warfarin by oral once a day,6months is a course of treatment. Clinical efficacy, coagulation, blood, antithrombin Ⅲ and intravascular ultrasound were observed, and whether there are adverse reactions and complications.Results:Experimental group and control group DVT patients were significantly improved after treatment, patients subjective symptoms such as pain, leg heaviness, etc. disappear, limb circumference difference<2cm, coagulation parameters were within the control range, vascular ultrasound examination showed recanalization.40patients in the experimental group, which cured33cases (82.5%), effective in6cases (15%), effective1case (2.5%), ineffective0case;40patients in the control group, which cured31cases (77.5%), effective in6cases (15%), effective in3cases (7.5%), ineffective0case; two groups’total effective rate are respectively97.5%and92.5%, the difference was not statistically significant (P=0.062). All patients in both groups during the treatment had no pulmonary embolism, bleeding and other serious complications.2patients of experimental group have microscopic hematuria, one patient had a small amount of nose bleeding, no other adverse reactions;1patients of control group has significantly reduced platelet thrombus but no increased performance, and2patient with oral gingival bleeding and hematuria, about1/3of patients with subcutaneous low molecular heparin site bruising and pain. Conclusions:To conclude, in this study, the treatment of deep vein thrombosis, the clinical efficacy of argatroban team is undifferentiated.And there is no apparent side effect and complications during the treatment. Therefore, the treatment of lower extremity DVT with argatroban is safe and effective, can be used clinically.