新型抗凝药达比加群酯对高龄持续性房颤导管射频消融术围术期的抗凝疗效及安全性评价  

Anticoagulant effects and safety evaluation of new anticoagulant dabigatran etexilate on the perioperative of persistent atrial fibrillation elder patients who took RFCA

作　　者：江云东[1] 杨思进[1] 白雪[1] 唐红梅[1] 江燕[1] 

机构地区：[1]泸州医学院附属中医院心脑病科,四川泸州646000

出　　处：《中国新药与临床杂志》2015年第9期671-675,共5页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的观察新型抗凝药达比加群酯对高龄持续性心房颤动患者导管射频消融术(RFCA)围术期的抗凝疗效,并进行安全性评价。方法选取2012年7月至2014年7月期间收治的高龄(≥75岁)持续性房颤患者84例,所有患者均拟行RFCA。采用随机数字表法将患者分为华法林组和达比加群酯组,均n=42。华法林组术前给予法华林(2.5 mg,qd)治疗1个月,术中给予低分子肝素钠(100 U·kg-1)治疗,术后继续给予法华林(2.5 mg,bid)治疗3个月。达比加群酯组给予达比加群酯(55 mg,bid)治疗1个月,术中给予低分子肝素钠治疗,术后继续给予达比加群酯治疗3个月。比较观察两组患者凝血功能和并发症。结果与治疗前相比,治疗1个月和术后3个月两组患者的凝血功能包括凝血酶原时间(PT)、活化的部分凝血活酶时间(APTT)、凝血酶时间(TT)、国际标准化比值(INR)比较均显著升高(P<0.05),且术后3个月各指标改变更显著(P<0.05);达比加群酯组的APTT、TT和INR显著高于华法林组(P<0.05)。华法林组术中及术后并发症均高于达比加群酯组(P<0.05)。结论达比加群酯在高龄持续性房颤患者RFCA围手术期的抗凝疗效好,能增强抗凝血功能,降低术中和术后并发症发生率。AIM To observe the anticoagulant effects and safety evaluation of dabigatran etexilate on the perioperative of persistent atrial fibrillation elder patients who accepted radiofrequency catheter ablation （RFCA）. METHODS Select 84 persistent atrial fibrillation elder patients （ ≥ 75 years old） that will take RFCA from July 2012 to July 2014. The patients were randomly divided into warfarin group and dabigatran etexilate group, 42 patients in each. The random number table established matched with their hospitalization sequence number. The patients in the warfarin group were given warfarin （2.5 mg, qd） preoperatively for 1 month, low molecular weight heparin intraoperatively （100 U .kg^-1） and warfarin postoperatively for three months （2.5 mg, bid）. The patients in the dabigatran etexilate group were given dabigatran etexilate （55 mg, bid） preoperatively for one month, low molecular weight heparin intraoperatively, and dabigatran etexilate postoperatively for three months. The blood coagulation function and the complications were observed. RESULTS The prothrombin time （ PT ） , activated partial thromboplastin time （ AFFF ） , thrombin time （ TT ） and international normalized ratio （INR） from the two groups in one month treatment and three months treatment were significantly higher than pre-treatment （P 〈 0.05）. The data from three months treatment were changed more significantly than that from one month treatment （P 〈 0.05）. The APTT, TF and INR from the warfarin group were significantly higher than that from the dabigatran etexilate group （P 〈 0.05）. The intraoperative and the postoperative complications in the dabigatran etexilate group were lower than that in the warfarin group （P 〈 0.05）. CONCLUSION The anti patients who took RFCA were complications as well. coagulant effects of dabigatran etexilate exact, which can improve the blood on persistent atrial fibrillation elder anticoagulation function, lower thecomplications as well.

关 键 词：达比加群酯 心房颤动 导管消融术 射频 围手术期 抗凝药 安全 

分 类 号：R973.2[医药卫生—药品]