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预防性使用依度沙班是否会增加全髋关节置换术后的D-二聚体水平?

Does Prophylactic Administration of Edoxaban Increase D-Dimer Levels after Total Hip Arthroplasty?

作者信息

Kawai Toshiyuki, Kuroda Yutaka, Goto Koji, Matsuda Shuichi

机构信息

Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan.

出版信息

J Clin Med. 2019 May 14;8(5):678. doi: 10.3390/jcm8050678.

Abstract

This study aimed to examine the effect of thromboprophylactic edoxaban on D-dimer levels and anemia after total hip arthroplasty (THA). We retrospectively analyzed data from 349 patients undergoing primary THA. Univariate regression and multivariate regression analyses were performed with D-dimer levels on the 7th, 14th, and 21st days postoperatively as the dependent variable Edoxaban use, age, sex, body mass index (BMI), renal function, drop in hemoglobin (Hb) drop, intraoperative blood loss and duration of surgery as were independent variables. Multivariate regression analysis was also performed with Hb drop as the dependent variable. Edoxaban administration of 15 mg/day and 30 mg/day after THA was correlated with higher D-dimer levels at 21, but not at 7 or 14, days postoperatively. Other significant independent predictors for high D-dimer levels were the duration of surgery (at 7 and 14 days), BMI (at 7 days), sex (at 14 days), and age (at 14 and 21 days). Edoxaban use was significantly, weakly correlated with a larger Hb drop at 7 and 14 days, but this was less than a clinically important difference. D-dimer levels after THA can be elevated by thromboprophylactic edoxaban after three weeks postoperatively.

摘要

本研究旨在探讨预防性使用依度沙班对全髋关节置换术(THA)后D - 二聚体水平及贫血的影响。我们回顾性分析了349例行初次THA患者的数据。以术后第7天、14天和21天的D - 二聚体水平为因变量,以依度沙班的使用、年龄、性别、体重指数(BMI)、肾功能、血红蛋白(Hb)下降、术中失血及手术时长为自变量,进行单因素回归和多因素回归分析。同时,以Hb下降为因变量进行多因素回归分析。THA后每日服用15 mg和30 mg依度沙班与术后21天较高的D - 二聚体水平相关,但与术后7天或14天无关。其他导致D - 二聚体水平升高的显著独立预测因素包括手术时长(术后7天和14天)、BMI(术后7天)、性别(术后14天)和年龄(术后14天和21天)。在术后7天和14天,依度沙班的使用与更大的Hb下降显著但微弱相关,不过这一差异小于具有临床意义的差异。THA术后三周,预防性使用依度沙班可使D - 二聚体水平升高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8636/6571743/0c478d964a14/jcm-08-00678-g001.jpg

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