摘要
目的利用食管超声对高龄心房颤动伴血栓形成患者经不同强度华法林与利伐沙班抗凝治疗后作血栓检出率及安全性比较。方法选取确诊有左心房血栓形成的非瓣膜性高龄房颤(75~80岁)患者54例,随机分为低强度华法林抗凝组(低强度组),标准强度华法林抗凝组(标准强度组),利伐沙班抗凝组(利伐沙班组),每组18例。观察期为12个月。比较3组患者左心房血栓检出率、血栓栓塞事件率及严重出血发生率。结果 12个月时低强度组左心房血栓检出率22.2%,标准强度组检出率22.2%,利伐沙班组检出率16.7%,3组比较差异无统计学意义(P>0.05)。低强度组血栓栓塞事件发生率为16.7%,标准强度组发生率为11.1%,利伐沙班组发生率为11.1%,3组比较差异无统计学意义(P>0.05)。低强度华法林组严重出血事件发生率为16.7%,标准强度华法林组为27.8%,利伐沙班组为11.1%,低强度组与利伐沙班组比较,严重出血事件发生率无统计学意义(P>0.05),标准强度组的出血发生率高于低强度组以及利伐沙班组患者,差异均有统计学意义(均P<0.05)。结论应用低强度华法林与利伐沙班抗凝在高龄房颤伴血栓形成的患者治疗中,两者治疗左心房血栓的疗效确切,出血风险无增加,安全性好。
Objective To compare the anticoagulation efficacy and safety of warfarin in different intensity and rivaroxaban for elderly patients with atrial fibrillation. Methods Fifty four patients aged 75-80 years with non-valvular atrial fibrillation and left atrial thrombus were randomly assigned in three groups with 18 cases in each group： patients received low intensity warfarin, standard intensity warfarin or rivaroxaban for anticoagulation therapy. Patients were followed up for 12 months. The detection rates of thrombus in left atrial,thromboembolic events and the incidence of severe bleeding were compared among three groups. Results The detection rates of the thrombus in low intensity warfarin, standard intensity warfarin and rivaroxaban groups were 22.2%, 22.2% and 16.7%, respectively（P〉0.05）.The incidence of thromboembolic events in three groups was 16.7%, 11.1% and 11.1%, respectively（P〉0.05）. The severe bleeding rate in standard intensity warfarin group was significantly higher than that in other two groups（27.8% vs. 16.7% and 11.1%, P〈0.05）; while there was no significant difference between low intensity group and rivaroxaban group（P〉0.05）. Conclusion The low intensity warfarin and rivaroxaban are effective and safe in anticoagulation treatment for elderly patients with atrial fibrillation and thrombosis.
作者
黄芳芳
汤云霞
翁少翔
HUANG Fangfang;TANG Yunxia;WENG Shaoxiang(Department of Cardiology,Deqing People＇s Hospital,Huzhou 313200,China)
出处
《浙江医学》
CAS
2018年第11期1199-1201,1225,共4页
Zhejiang Medical Journal
关键词
心房颤动
左心耳血栓
华法林
低强度抗凝
利伐沙班
Atrial fibrillation
Left atrial thrombosis
Warfarin Low intensity anticoagulation
Rivaroxaban
