| Objective:Dynamic monitoring of common coagulation function and thromboelastogram(TEG)before and after oral administration of rivaroxaban in patients with venous thromboembolism(VTE)to investigate the effects of routine coagulation parameters and TEG on the anticoagulation efficacy of rivaroxaban.Methods:Select 2017.3-2017.11 admitted to the Shanxi Dayi Hospital of Vascular Surgery Department has confirmed 80 cases of patients with deep vein thrombosis of the lower extremities,including 34 males and 46 females,aged 21-74 years old.Routine oral rivaroxaban tablets were used in all patients for out-of-hospital anticoagulation regimens.Each patient received anticoagulant therapy,oral rivaroxaban 3 days,oral rivaroxaban 1month,and after 3 months.General coagulation function and TEG examination were performed.The specific test parameters included PT,APTT,Fib,D-dimer,R value,K value,Angle value,and MA value.The blood specimens for each examination were left for three hours after oral administration of the drug.take.The common coagulation function was detected by an automatic coagulation analyzer.The TEG test was performed using a US-based TEG@5000 thrombelastograph from Haemoscope.A single-factor repeated-measures analysis of variance was used to compare the dynamic changes of patients' common coagulation parameters and TEG indicators for four time periods.?Results:Analysis of conventional coagulation tests in 80 patients at four time periods(before anticoagulant therapy,3 days after taking rivaroxaban,1 month after taking rivaroxaban,and 3 months after taking rivaroxaban): Compared with before treatment,the PT value was significantly prolonged,and the D-dimer value was significantly reduced(P < 0.05).Fib and APTT values were not statistically different(P > 0.05).TEG test results showed that: R value and K value were prolonged after administration,and the difference was statistically significant(P < 0.05).Angles and MA values were not significantly changed(P > 0.05).Comparing each indicator's time interval between the two,it can be seen that PT was significantly prolonged compared with the three days after taking the drug,one month after taking the drug,and three months after taking the drug.The difference was statistically significant(P < 0.05).However,there was no significant difference between the three days after taking the medicine,one month after taking the medicine,and three months after taking the medicine.The difference was not statistically significant(P>0.05);the D-dimer was taken before and after taking the medicine.The days,1 month after taking the drug,and 3 months after taking the drug showed that the index value gradually decreased with time,and the difference was statistically significant(P < 0.05).Fib and APTT were taken before and after taking the drug.There was no significant change in days,1 month after medication,and 3 months after medication.The difference was not statistically significant(P>0.05);R value and K value in TEG was 3 days after medication,1 month after medication,and 3 months after medication.The difference was statistically significant before medication(P < 0.05),but there was no significant change between the three days after taking the drug,one month after taking the drug,and three months after taking the drug.The difference was not statistically significant(P>0.05);Angle angle,MA value did not change significantly before taking rivaroxaban,three days after taking medicine,one month after taking medicine,and three months after taking medicine.The difference was not statistically significant(P>0.05).Conclusion:1.The PT value in the routine coagulation test is significantly prolonged,its sensitivity is related to the test reagents,and clinically it is not often used as a method for monitoring the efficacy of rivaroxaban;the D-dimer value is significantly reduced and over time within 3 months of taking the drug.The prolongation gradually decreased,clinically used as an indicator to assess thrombosis statusThe D-dimer value was significantly decreased and gradually decreased with the prolonged time within 3 months of taking the drug.2.The R-value and K-value of the thrombelastogram test are prolonged.There are no specific indicators for monitoring the anticoagulant efficacy of rivaroxaban in clinical practice.The R value and K value of the TEG test indicators are prolonged after oral administration of rivaroxaban in VTE patients.The detection method is simple,rapid,accurate,and can be used as a detection method to monitor the anticoagulant effect of rivaroxaban... |
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