新型抗凝药与华法林对非瓣膜性心房颤动患者抗凝效果的临床评价
作者:
作者单位:

(1.复旦大学附属华山医院静安分院心内科,上海市 200040;2.上海交通大学附属瑞金医院消化科,上海市 200025)

作者简介:

黄芳,住院医师,研究方向为心律失常,E-mail:761337469@qq.com。

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基金项目:

国家自然科学基金资助项目(81970126)


Clinical evaluation of anticoagulation effect of new anticoagulants and warfarin in patients with non-valvular atrial fibrillation
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Affiliation:

1.Department of Internal Medicine-Cardiovascular, Jing'an Branch of Huashan Hospital Affiliated to Fudan University, Shanghai 200040, China;2.Digestive Department, Ruijin Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200025, China)

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    摘要:

    目的]研究利伐沙班、达比加群酯与华法林对非瓣膜性心房颤动抗凝效果。[方法]收集心内科接收的120例非瓣膜性心房颤动住院患者为研究对象,均服用单一抗凝药物,分为华法林组(40例)、利伐沙班组(40例)和达比加群酯组(40例),接受药物治疗6个月,比较治疗期间栓塞事件、出血事件发生率和血常规、肝肾功能及血栓弹力图指标情况。[结果]治疗6个月后,利伐沙班组和达比加群酯组栓塞事件发生率明显低于华法林组(P<0.05),而利伐沙班组与达比加群酯组比较差异无显著性(P>0.05);三组出血事件发生率、治疗前及治疗后6个月患者血常规指标(白细胞计数、血小板计数、血红蛋白)、肝肾功能指标(血清肌酐、谷丙转氨酶、血尿素氮)比较差异无显著性(P>0.05);治疗6个月后利伐沙班组与达比加群酯组血栓弹力图指标R值、K值、MA值均明显高于华法林组(P<0.05),但利伐沙班组与达比加群酯组比较差异无显著性(P>0.05)。[结论]利伐沙班、达比加群酯治疗非瓣膜性心房颤动相比华法林具有更优的抗凝效果,降低栓塞事件的发生,且对肝肾功能及血常规无明显影响,安全性高。

    Abstract:

    Aim To study the anticoagulant effect of rivaroxaban, dabigatran etexilate and warfarin in patients with non-valvular atrial fibrillation. Methods 120 patients with non-valvular atrial fibrillation who were admitted to our department of cardiology or outpatient clinic from January 2016 to January 2018 were enrolled in this study. All patients were treated with a single anticoagulant and divided into warfarin group (40 cases), rivaroxaban group (40 cases), dabigatran group (40 cases), receiving drug treatment for 6 months, and comparing embolization events, bleeding events, blood routine, liver and kidney function and thromboelastography indicators during treatment. Results After 6 months of treatment, the incidence of embolization events in the rivaroxaban group and dabigatran group was significantly lower than that in the warfarin group (P<0.05); There was no significant difference in the rivaroxaban group and dabigatran group (P>0.05). It can be seen that rivaroxaban and dabigatran etexilate are more helpful in preventing embolism. There were no significant differences in bleading incidence rate, blood routine parameters (white blood cell count, platelet count, hemoglobin) and liver and kidney function indexes (SCr, ALT, BUN) among the three groups at pre-treatment and 6 months after treatment (P>0.05). The R,Kü and MA values of thrombus elasticity index in rivaroxaban group and dabigatran group were significantly higher than those in warfarin group (P<0.05); There was no significant difference in R value,Kü value and MA value between the rivaroxaban group and the dabigatran group after 6 months (P>0.05). Conclusion Compared with warfarin, rivaroxaban and dabigatran etexilate have better anticoagulant effects in patients with non-valvular atrial fibrillation, which decrease embolization events but have no obvious effect on liver and kidney function and blood routine with high safety.

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黄芳,王永康.新型抗凝药与华法林对非瓣膜性心房颤动患者抗凝效果的临床评价[J].中国动脉硬化杂志,2022,30(9):773~777.

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  • 收稿日期:2021-10-18
  • 最后修改日期:2022-01-23
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  • 在线发布日期: 2022-07-30