达比加群酯应用于轻中度肾功能不全的老年心房颤动患者射频消融术后的安全性观察  

Observation on the safety of dabigatran in elderly atrial fibrillation patients with mild to moderate renal dysfunction after radiofrequency ablation

作　　者：周红梅 徐瑾[1] 张清[1] 张琪[1] 姜萌[1] 卜军[1] ZHOU Hong-mei;XU Jin;ZHANG Qing;ZHANG Qi;JIANG Meng;BU Jun(Department of Cardiovascular,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200001,China)

机构地区：[1]上海交通大学附属仁济医院心内科,上海200001

出　　处：《世界临床药物》2018年第12期826-831,共6页World Clinical Drug

基　　金：上海交通大学医学院附属仁济医院院内培育基金(PYIII-17-034)

摘　　要：目的观察达比加群酯应用于轻中度肾功能不全的老年心房颤动(房颤)患者射频消融术后的安全性。方法根据病例入院时肾小球滤过率估算值(e GFR),将纳入研究的94例老年房颤患者分为正常肾功能组(n=27)、轻度肾功能不全组(n=51)及中度肾功能不全组(n=16)三组。三组患者均接受射频消融治疗,术后6 h开始服用达比加群酯(每次110 mg,一日2次)进行抗凝治疗,监测并比较三组患者用药前、术后48 h及术后1个月时的肝功能、肾功能、血细胞变化,并随访观察患者3个月内有无栓塞及出血事件发生。结果三组患者术后接受达比加群酯抗凝治疗均未发生大出血事件;三组患者间血栓栓塞事件无统计学差异;三组患者应用达比加群酯后监测肝肾功能均未见显著降低,且均无外周血细胞减少。结论达比加群酯应用于轻中度肾功能不全的老年房颤患者射频消融术后是安全的,短期的抗凝治疗不会加重肾功能恶化。Objective To observe the safety of dabigatran applied in elderly patients with atrial fibrillation and mild/moderate renal dysfunction after radiofrequency ablation.Methods A total of 94 elderly atrial fibrillation patients in hospital were selected,and divided into normal renal function group(n=27)and mild renal dysfunction group(n=51)and moderate renal dysfunction group(n=16)based on patients’ estimated glomerular filtration rate(eGFR).All three groups received radiofrequency ablation treatment,and the anticoagulant therapy started with dabigatran(110 mg twice a day) at 6 hours after operation.The renal and liver function and the blood cell data of these patients were measured at the before operation,48 hours after operation and 1 month after operation.And three months continuous observation for the occurrence of embolization and hemorrhage was made.Results There were no major bleeding events in the three groups of patients,who received dabigatran as anticoagulant therapy.There was no significant difference in thromboembolic events among the three groups,and neither the reduction in liver and kidney function.In the three group patients treated with dabigatran,no peripheral blood cell reduction was observed.Conclusion As an anticoagulant,dabigatran can safely use for the elderly atrial fibrillation patients with mild/moderate renal dysfunction after radiofrequency ablation.

关 键 词：心房颤动 肾功能不全 达比加群酯 射频消融术 

分 类 号：R453[医药卫生—治疗学]