Treatment Of Aescin Combined With Warfarin On Pulmonary Embolism With Endothelial Injury And Prognostic Impact

Background:Currently,long-term treatment of pulmonary embolism is subject to anticoagulation.While,it has discovered that pulmonary embolism is more likely to relapse once drugs are stopped during long-term follow-up visits.The recurrence rate of pulmonary embolism also increases year by year during process of long-term anticoagulation.Escin has been proved to act on vascular endothelium,having the effects of repairing the injured vascular endothelium.This study is intended to verify that Escin combined with the anticoagulant of Warfarin can effectively relieve vascular endothelial injury of patients with light pulmonary embolism,and reduce the recurrence of pulmonary embolism.Method:160 patients with initial pulmonary embolism from the First Affiliated Hospital of Kunming Medical University were recruited.Patients with pulmonary embolism were divided into two types according to whether their endothelial cells were damaged,and each kind of patients were randomly divided into two groups,which were given with Aescuven forte combined with Warfarin or single Warfarin respectively for 48 weeks.Standard treatment was carried out for Warfarin.INR was maintained between 2.0-3.0,and Escin was given twice per day,300mg each time.Follow-up visits were administered at the 3rd,6th,9th and 12th months after treatment,during which endothelial cells were reexamined.Effects of Escin on treatment of acute pulmonary embolism and on prognosis were evaluated,and exploratory analysis was carried out on endothelial cells in blood of each subgroup.Result:The number of endothelial cells before treatment was 5046.1±1519.68126/ml when patients with pulmonary embolism with endothelial injury were treated with Aescuven forte combined with Warfarin.The number of endothelial cells was reduced after treatment with a statistic difference(P<0.05).The number of endothelial cells before treatment was 4645.5667±1717.39702/ml when patients with pulmonary embolism with endothelial injury were treated with Warfarin separately.The number of endothelial cells was slightly reduced after treatment,and the difference had statistical significance(P<0.05).But,average value of endothelial cells was generally higher than that of the control group without statistic difference(P>0.05).Comparison of endothelial cells before and after treatment had no statistical significance no matter patients of pulmonary embolism without endothelial injury were treated with any kind of treatment scheme(P>0.05).There were 4 cases of relapse in a year that patients of pulmonary embolism with endothelial injury were treated with Aescuven forte combined with Warfarin,the accumulated recurrence rate of which was lower than other groups,and the difference had statistical significance(P<0.05).Conclusion:1.Pulmonary embolism and endothelial injury have a certain relationship;2.A new typing of pulmonary embolism can be made according to whether there is endothelial injury;3.This kind of typing is of significance in the treatment and prognosis of pulmonary embolism;4.Individualized treatment of pulmonary embolism is a new development trend in the future.