Clinical Study On The Treatment Of Deep Venous Thrombosis In Lower Extremity By Rivaroxaban And Gene Detection Guide Warfarin

ObjectiveTo investigate the clinical effect of Rivaroxaban and the dose of warfarin adjusted by CYP2C9 and VKORC1 genotypes in the treatment of deep vein thrombosis of the lower extremities.MethodsA total of 152 patients with deep venous thrombosis of the lower extremities who were admitted to hospital for vascular surgery in the provincial hospital of Anhui medical university from January 2017 to January 2018 were selected and divided into a Rivaroxaban group(n=76)and a genetic testing group(n=76)according to the treatment plan.The Rivaroxaban group was treated with Rivaroxaban and the gene test group was given warfarin according to the results of CYP2C9 and VKORC1 gene detection(using polymerase chain reaction-restriction fragment length polymorphism).After 6 months of treatment,the patients were followed up to record the change of limb circumference difference,lower limb deep vein thrombus treatment efficient,quality of healthy life scores,adverse reactions.ResultsFollow-up after 6 months of treatment showed that the effective rate of rivaroxaban group and gene test group was 86.84% and 77.14% respectively,and the difference between the two groups was statistically significant(P<0.05).The scores of life and health quality were statistically different between the two groups(P<0.05).Clinical bleeding and other adverse events: 2 cases in rivaroxaban group and 8 cases in gene test group,the difference between the two groups was statistically significant(P<0.05).According to the recommended warfarin dose of(3.25+1.05)mg by the pharmacogenomics testing laboratory,the actual dose of warfarin when 70 patients reached the anticoagulant index(INR2-3)was(3.57+0.98)mg,and the difference was not statistically significant(P >0.05).ConclusionsThe effective rate of rivaroxaban in the treatment of lower limb venous thrombosis is better,which can improve the quality of life after treatment.In addition,the incidence of bleeding events in the rivaroxaban group is lower than that in the genetic test group,and the genetic test is of reference significance for the selection of initial warfarin dose.