目的 探讨高龄下肢深静脉血栓患者利伐沙班血药浓度的影响因素。方法 回顾性分析2019年1月至2022年12月南京鼓楼医院血管外科收治的262例高龄下肢深静脉血栓患者的利伐沙班血药浓度,分析不同剂量组峰浓度和谷浓度的分布情况,采用单因素回归分析和多重线性回归分析探究年龄、性别、身体质量指数(body mass index, BMI)以及肾功能等因素与利伐沙班血药浓度的相关性。结果 患者的利伐沙班峰浓度和谷浓度在不同剂量组之间存在着统计学差异,峰浓度3组之间两两相比差异均有统计学意义(P值均<0.05),20 mg组患者的谷浓度均高于10 mg组及15 mg组(P值均<0.05);单因素分析中影响利伐沙班峰浓度的因素有年龄、BMI、肾功能以及胺碘酮,影响利伐沙班谷浓度的因素有年龄、BMI和肾功能,而多重线性回归分析中,仅筛选出BMI和肾功能,其余因素则被剔除。结论 BMI和肾功能与利伐沙班峰浓度和谷浓度有相关性,因此对于异常体重或者肾功能不全的高龄患者,血药浓度监测可以用于评估患者体内利伐沙班水平。
Abstract
OBJECTIVE To investigate the influencing factors of rivaroxaban blood concentration in elderly patients with deep vein thrombosis. METHODS The plasma concentrations of rivaroxaban in 262 elderly patients with deep vein thrombosis admitted to the Department of Vascular Surgery in Nanjing Drum Tower Hospital from January 2019 to December 2022 were retrospectively collected, and the distribution of peak concentrations and trough concentrations in different dose groups were analyzed. Univariate analysis and multiple linear regression analysis were used to explore the correlation between age, gender, body mass index (BMI), renal function and rivaroxaban blood concentration. RESULTS There were statistical differences in the peak and trough concentrations of rivaroxaban among different dose groups. Pairwise comparisons between the three groups in peak concentrations revealed significant differences, respectively (all P<0.05), and the trough concentrations of patients in the 20 mg group were higher than those in the 10 mg and 15 mg groups, respectively (all P<0.05). In univariate analysis, the factors affecting the peak concentration of rivaroxaban were age, BMI, renal function and amiodarone, and the factors affecting the trough concentration of rivaroxaban were age, BMI and renal function. But in the multiple linear regression analysis, only BMI and renal function were screened out as independent variables, while other factors were excluded. CONCLUSION BMI and renal function are related with the peak and trough rivaroxaban concentrations. Therefore, blood concentration monitoring can be used to assess rivaroxaban level in elderly patients with abnormal weight or renal insufficiency.
关键词
深静脉血栓 /
高龄患者 /
利伐沙班 /
血药浓度
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Key words
deep vein thrombosis /
elderly patient /
rivaroxaban /
blood concentration
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中图分类号：
R917
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参考文献
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脚注
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基金
国家自然科学基金项目资助(81900427);南京鼓楼医院临床研究专项资金项目资助(2021-LCYJ-PY-19);南京药学会-常州四药医院药学科研基金项目资助(2020YX003)
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