目的 探讨羟苯磺酸钙联合利伐沙班治疗下肢深静脉血栓形成后综合征的临床疗效。方法 选取2020年8月—2024年7月晋江市医院收治的下肢深静脉血栓形成后综合征患者86例，按照随机数字法分为对照组（43例）和治疗组（43例）。对照组患者口服利伐沙班片，10 mg/次，1次/d。在对照组的基础上，治疗组口服羟苯磺酸钙片，500 mg/次，1次/d。两组用药30 d后观察治疗情况。观察两组临床疗效，比较治疗前后两组患者症状好转时间，静脉临床严重程度评分（VCSS）和Villalta评分，凝血指标活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）和凝血酶原时间（PT），及血清炎性因子D-二聚体（D-D）、细胞间黏附分子-1(ICAM-1)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平。结果 治疗后，治疗组总有效率（95.35%）明显高于对照组的总有效率（79.07%,P<0.05）。治疗后，治疗组下肢肿胀、下肢疼痛、下肢浅静脉扩张、下肢皮肤暗红改善时间均明显短于对照组（P<0.05）。治疗后，两组患者VCSS评分和Villalta评分比治疗前明显降低（P<0.05），且治疗组评分明显低于对照组（P<0.05）。治疗后，两组患者APTT、PT水平均明显高于治疗前，而FIB水平明显降低（P<0.05），且治疗组凝血指标水平明显好于对照组（P<0.05），治疗后，两组患者D-D、ICAM-1、TNF-α、IL-6水平比治疗前明显降低（P<0.05），且治疗组炎性因子水平均明显低于对照组（P<0.05）。结论 羟苯磺酸钙与利伐沙班协同治疗能对患者的症状和体征起到好转作用，并能改善凝血功能和降低机体炎性反应,能使静脉回流情况改善。

Objective To explore the clinical efficacy of calcium dobesilate combined with rivaroxaban in treatment of lower limb deep vein thrombosis syndrome. Methods Patients（86 cases） with lower limb deep vein thrombosis syndrome in Jinjiang Hospital from August 2020 to July 2024 were divided into control（43 cases） and treatment（43 cases） group according to random number method. Patients in the control group were po administered with Rivaroxaban Tablets, 10 mg/time, once daily. Patients in the treatment group were po administered with Calcium Dobesilate Tablets, 500 mg/time, once daily. Patients in two groups were treated for 30 d. After treatment, the clinical evaluations were evaluated, the symptom relief time, VCSS and Villalta scores, the coagulation indexes APTT, PT, and FIB, and the inflammatory factors D-D, ICAM-1, TNF-α, and IL-6 in two groups before and after treatment were compared. Results After treatment, the effective rate in the treatment group（95.35%） was significantly higher than that in the control group（79.07%, P＜0.05）. After treatment, the improvement time of lower limb swelling, pain, superficial venous dilation and dark red skin in the treatment group was significantly shorter than that in the control group（P＜0.05）. After treatment, the VCSS scores and Villalta scores in two groups were significantly lower than those before treatment（P＜0.05）, and the scores in the treatment group were significantly lower than those in the control group（P＜0.05）. After treatment, the levels of APTT and PT in two groups were significantly higher than those before treatment, but the levels of FIB were significantly lower（P＜0.05）, and the levels of coagulation indicators in the treatment group were significantly better than those in the control group（P＜0.05）. After treatment, the levels of DD, ICAM-1, TNF-α, and IL-6 in two groups were significantly lower than those before treatment（P＜0.05）, and the levels of inflammatory factors in the treatment group were significantly lower than those in the control group（P＜0.05）. Conclusion The synergistic treatment of calcium dobesilate and rivaroxaban can improve the symptoms and signs, improve coagulation function and reduce the inflammatory response, and improve venous reflux.

R973

福建省自然科学基金资助项目(2023J01653)