三种不同抗凝方式用于心房颤动导管消融术患者中的临床效果及经济成本对比分析  

Clinical Effects and Costs of Three Different Anticoagulation Modes in Patients with Atrial Fibrillation Catheter Ablation

作　　者：赵荣诚[1] 韩佳[1] 付金玲[1] ZHAO Rongcheng;HAN Jia;FU Jinling(Department of Cardiology,Cangzhou Central Hospital,Cangzhou Hebei 061001,China)

机构地区：[1]沧州市中心医院心血管内科,河北沧州061001

出　　处：《解放军预防医学杂志》2018年第2期191-193,共3页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：沧州市科技支撑计划项目(No.1123028ZD)

摘　　要：目的探讨达比加群、利伐沙班及华法林用于心房颤动导管消融术患者中的临床效果及经济成本。方法以2015年2月-2017年2月在我院行房颤射频消融术的120例患者为研究对象,根据治疗方式分为达比加群组、利伐沙班组和华法林组,分析比较三组的治疗效果和治疗成本。结果治疗后,达比加群组和利伐沙班组活化的部分凝血活酶时间(APTT)、凝血酶时间(TT)明显长于华法林组(P<0.05)。达比加群组和利伐沙班组并发症发生率明显低于华法林组(P<0.05)。3组患者不良反应发生情况比较无显著差异(P>0.05)。达比加群组、利伐沙班组及华法林组患者每人每年药物费用分别为12 168元、24 120元及108元,华法林组患者总费用明显低于达比加群组和利伐沙班组患者。结论达比加群和利伐沙班用于心房颤动导管消融术后抗凝治疗中,临床效果与华法林相当,但费用较高,根据我国平均经济水平来看,华法林经济有效。Objective To investigate the clinical effects and costs of dabigatran,rivaroxaban and warfarin in patients with atrial fibrillation catheter ablation.Methods One hundred and twenty patients undergoing AF in our hospital between February 2015 and February 2017 were studied.They were divided into the dabigatran group,rivaroxaban group and warfarin group according to the mode of treatment.The therapeutic effect and treatment costs were analyzed and compared between the two groups.Results After treatment,the activated partial thromboplastin time(APTT)and thrombin time(TT)in the dabigatran group and the rivaroxaban group were significantly longer than those in the warfarin group(P<0.05).The incidence of complications in the dabigatran group and rivaroxaban group was significantly lower than that in the warfarin group(P<0.05).There was no difference in adverse reactions between the three groups(P>0.05).The annual cost of medication for patients in the dabigatran group,the rivaroxaban group and the warfarin group was 12 168 yuan,24 120 yuan and 108 yuan respectively.The total cost for patients in the warfarin group was significantly lower than that in the other two groups.Conclusion The use of dabigatran and rivaroxaban for anticoagulant therapy after atrial fibrillation catheter ablation is comparable to warfarin in clinical efficacy,but at a higher cost.According to China's average economic level,warfarin is cost-effective.

关 键 词：抗凝 达比加群 利伐沙班 华法林 心房颤动 导管消融术 

分 类 号：R541.7[医药卫生—心血管疾病]