Efficacy of enoxaparin combined with rivaroxaban in patients with acute intermediate-low-risk pulmonary embolism
FENG Jianguo
XU Gang
WANG Ping
ZHANG Yuchao
CHEN Maozhen
SHEN Mingyang
Abstract：Objective To investigate the clinical efficacy of enoxaparin combined with rivaroxaban in patients with acute intermediate-low-risk pulmonary embolism.Methods A total of 80 patients with acute intermediate-low-risk pulmonary embolism admitted to the Department of Vascular Surgery at Huai'an First People's Hospital between December 2023 and De-cember 2024 were retrospectively enrolled and divided into two groups based on previous treatment regimens.40 patients who received enoxaparin combined with rivaroxaban were assigned to the enoxaparin group,and another 40 patients who received rivaroxaban monotherapy were assigned to the rivaroxaban group.The coagulation function index,pulmonary ventilation pa-rameter,overall clinical efficacy,and drug-related adverse reactions were compared between the enoxaparin group and the rivar-oxaban group.Results After treatment,the activated partial thromboplastin time,prothrombin time,oxygen saturation at rest,tidal volume,and minute ventilation in the enoxaparin group((42.19±3.41)s,(18.54±2.47)s,(96.37±3.24)％,(464.37±9.64)mL,(8.65±1.24)L/min,respectively)were higher than those in the rivaroxaban group((39.64±3.37)s,(14.29±2.51)s,(89.03±3.15)％,(429.61±8.17)mL,(7.30±0.15)L/min,respectively),with statistically significant differences(t=13.913,7.633,10.273,17.397,6.836,all P＜0.05).After treatment,the levels of fibrinogen,D-dimer,and end-tidal carbon dioxide partial pressure in the enoxa-parin group((2.17±0.46)g/L,(1.04±0.23)mg/L,(5.14±0.17)mmHg(1 mmHg=0.133 kPa),respectively)were lower than those in the rivaroxaban group((3.17±0.27)g/L,(1.37±0.21)mg/L,(5.29±0.23)mmHg,respectively),with statistically significant differences(t=1 1.857,6.701,3.317,all P＜0.05).After treatment,the end-diastolic diameter of the right ventricle and pulmonary artery systolic pressure in the enoxaparin group were both lower than those before treatment,and the values in the enoxapa-rin group((27.18±2.85)mm and(28.41±5.24)mmHg,respectively)were lower than those in the rivaroxaban group((30.27±3.16)mm and(34.79±5.87)mmHg,respectively)(t=4.593,5.128,both P＜0.05).The total effective rate in the enoxaparin group was 95.00％(38/40),significantly higher than 75.00％(30/40)in the rivaroxaban group(x2=6.275,P＜0.05).There was no statis-tically significant difference in the incidence of adverse reactions between the enoxaparin group(20.00％(8/40))and the rivar-oxaban group(27.50％(11/40))(x2=0.621,P=0.431).Conclusion In the treatment of acute intermediate-low-risk pulmonary embolism,the combination of enoxaparin and rivaroxaban can more effectively improve patients'coagulation function and pul-monary ventilation,enhance clinical efficacy,without increasing additional risks,demonstrating a favorable safety profile.
Keywords：enoxaparinrivaroxabanacute intermediate-low-risk pulmonary embolismcoagulation functionpulmo-nary ventilation function
Publication Date：2026-01-25
Online Publishing Date：2026-03-03(First online date of this platform, not the publication date of the document)
Pages：5( 82-86 )