摘要
目的对比研究老年非瓣膜性房颤患者应用利伐沙班、达比加群及华法林预防血栓栓塞事件的有效性及用药安全性。方法选取2016年4月至2018年4月我科病房及门诊治疗的138例老年非瓣膜性房颤患者作为研究对象,随机分为利伐沙班组、达比加群组及华法林组,每组各46例,随访6个月,比较3组患者血栓栓塞事件、出血事件、不良发应的发生率和3组患者治疗前后的凝血指标、血小板计数及肝肾功能。结果 3组患者血栓栓塞事件的发生率相当,差异无统计学意义(P> 0.05)。利伐沙班组、达比加群组的出血事件发生率均较华法林组低,但差异无统计学意义(P> 0.05)。达比加群组的消化系统不良反应的发生率较其他2组高,但差异无统计学意义(P> 0.05)。抗凝治疗后,华法林组INR、PT明显延长,与其他2组比较,差异有统计学意义(P<0.05);利伐沙班组的PT、aPTT和达比加群组的TT、aPTT均较治疗前延长,但与治疗前比较,差异无统计学意义(P> 0.05)。3组aPTT、TT、PLT、ALT、Scr的组间比较,差异无统计学意义(P> 0.05)。结论利伐沙班、达比加群对预防老年非瓣膜性房颤患者血栓栓塞事件的有效性与华法林相当,但出血风险较华法林低。
Objective To compare efficacy and safety of Rivaroxaban,Dabigatran and Warfarin for prevention of thromboembolic events in senile patients with nonvalvular atrial fibrillation. Methods One hundred and thirty-eight senile patients with nonvalvular atrial fibrillation admitted to our department between April 2016 and April 2018 were randomly divided into Rivaroxaban group( n = 46),Dabigatran group( n = 46)and Warfarin group( n = 46). These patients were followed up for 6 months. To compare the incidence of the three groups on thromboembolic events,bleeding events and adverse reactions,meanwhile,to compare the coagulation index,platelet count and liver and kidney function of the three groups before and after therapy. Results There was no statistically significant difference in the incidence of thromboembolic events between the three groups( P > 0. 05). The incidence of bleeding events between the Rivaroxaban group and the Dabigatran group was lower than that in the Warfarin group,but there was no statistically significant difference between the three groups( P > 0. 05). There was no statistically significant difference in the incidence of adverse reactions between the three groups( P > 0. 05). The incidence of adverse reactions in digestive system was higher than the other two groups,but there was no statistically significant difference between the three groups( P > 0. 05). These INR、PT of the Warfarin group were significantly prolonged,compared with the other two groups,the difference was statistically significant( P <0. 05). There was no statistically significant difference in these aPTT、TT、PLT、ALT、Scr of the three groups before and after therapy( P > 0. 05).Conclusion The efficiency of Rivaroxaban and Dabigatran is equal to Warfarin for prevention of thromboembolic events in senile patients with nonvalvular atrial fibrillation,but Rivaroxaban and Dabigatran have lower bleeding risk than Warfarin.
作者
左楠楠
王翀
ZUO Nan-nan;WANG Chong(Department of veteran cadres,The Central Hospital of Yingkou,Yingkou,115000,China)
出处
《血栓与止血学》
CAS
2022年第1期7-10,共4页
Chinese Journal of Thrombosis and Hemostasis
关键词
心房颤动
抗凝药
老年人
栓塞
对比研究
Atrial fibrillation
Anticoagulants
Aged
Embolism
Contrastive studies
