摘要
目的观察比较抗凝药物华法林和利伐沙班对非瓣膜性房颤患者血清炎性因子及微RNA-29b(miR-29b)、微RNA-223(miR-223)表达的影响。方法前瞻性选取146例非瓣膜性房颤患者,根据1∶1配对原则随机分组进行对照研究,每组73例(华法林组予以华法林,利伐沙班组予以利伐沙班)。比较两组栓塞或血栓形成、脑出血发生率、出血事件发生率及治疗前后凝血功能[凝血酶原时间(PT)、国际标准化比值(INR)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)]指标、血清炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]、miR-29b、miR-223。结果疗程结束后,两组PT、TT、APTT、INR、血清miR-29b水平高于治疗前,IL-6、hs-CRP、TNF-α、miR-223水平低于治疗前,差异有统计学意义(P<0.05)。两组疗程结束后PT、TT、APTT、INR、血清IL-6、hs-CRP、TNF-α、miR-223、miR-29b相比,差异无统计学意义(P>0.05)。两组栓塞或血栓形成、脑出血发生率相比,差异无统计学意义(P>0.05)。利伐沙班组出血性事件发生率低于华法林组,差异有统计学意义(P<0.05)。结论华法林、利伐沙班均能改善非瓣膜性房颤患者凝血功能,降低炎性反应,调控血清miR-29b、miR-223水平,但利伐沙班有助于降低出血性事件发生率的效果。
Objective To investigate the effect of different anticoagulants on the expression of serum inflammatory factors and microRNA-29 b(miR-29 b)and miR-223 in patients with nonvalvular atrial fibrillation.Methods One hundred and forty-six patients with nonvalvular atrial fibrillation were prospectively selected,and randomly divided into controlled study based on the 1∶1 matching principle(n=73).Group A was given with warfarin and Group B was given with rivaroxaban.The two groups were compared for embolism or thrombosis,the incidence of cerebral hemorrhage,the incidence of bleeding events,coagulation function[prothrombin time(PT),international normalized ratio(INR),activated partial thromboplastin time(APTT),thrombin time(TT)]index,serum inflammatory factors[interleukin 6(IL-6),tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP)],miR-29 b,miR-223 before and after treatment.Results After the course of treatment,the levels of PT,TT,APTT,INR,and serum miR-29 b in the two groups were significantly higher than those before treatment;and the levels of IL-6,hs-CRP,TNF-α,and miR-223 were significantly lower than those before treatment(P<0.05).There was no significant difference in PT,TT,APTT,INR,serum IL-6,hs-CRP,TNF-α,miR-223,or miR-29 b between the two groups after treatment(P>0.05).There was no significant difference in the incidence of embolism/thrombosis orcerebral hemorrhage between the two groups(P>0.05).The incidence of bleeding events in Group B was significantly lower than that in Group A(P<0.05).Conclusion Warfarin and rivaroxaban can improve the coagulation function of patients with non-valvular atrial fibrillation,reduce the inflammatory response,and regulate serum miR-29 b and miR-223 levels,but rivaroxaban helps reduce the incidence of bleeding events.
作者
李庆勇
汤宝鹏
牛锁成
刘素萍
芦颜美
苏金玲
LI Qing-yong;TANG Bao-peng;NIU Suo-cheng;LIU Su-ping;LU Yan-mei;SU Jin-ling(Department of Cardiology,Puyang People's Hospital,Puyang 457000,Henan,China;不详)
出处
《广东医学》
CAS
2021年第4期415-419,共5页
Guangdong Medical Journal
基金
国家自然科学基金资助项目(81570297)。
