达比加群联合华法林应用于房颤PCI术后的抗凝治疗效果及安全性分析  

Efficacy and safety of dabigatran combined with warfarin in anticoagulation therapy after atrial fibrillation

作　　者：王志强 蒋娜 WANG Zhi-qiang;JIANG Na(The Ninth People's Hospital of Zhengzhou 450000,Zhengzhou 450000,China)

机构地区：[1]郑州市第九人民医院,郑州450000

出　　处：《医药论坛杂志》2020年第6期71-74,共4页Journal of Medical Forum

摘　　要：目的探讨房颤冠脉介入术(PCI)后患者采用达比加群联合华法林抗凝治疗的效果及安全性。方法纳入2018年5月—2019年5月期间郑州市第九人民医院收治的106例房颤PCI术后患者作为本次研究对象,掷币法将其分为对照组和观察组,两组患者均接受常规基础治疗包括低分子肝素、阿司匹林、氯吡格雷等,对照组53例患者在常规基础治疗上加用华法林钠片治疗,观察组53例患者在常规基础治疗上加用达比加群酯胶囊治疗,两组均持续治疗6个月,6个月后对比两组患者实验室指标(血小板计数、C反应蛋白、D-二聚体、血浆纤维蛋白原)及凝血指标(凝血酶原时间、凝血酶时间、活化部分凝血活酶时间、凝血酶原时间国际标准化比值)。结果治疗后,观察组患者血小板计数、C反应蛋白、D-二聚体及血浆纤维蛋白原均低于对照组,差异显著(P<0.05);对照组凝血酶时间及活化部分凝血活酶时间均低于观察组,对照组凝血酶原时间高于观察组,对照组凝血酶原时间国际标准化比值高于观察组,差异具有统计学意义(P<0.05);观察组患者肺栓塞、下肢静脉栓塞及出血性脑卒中等不良事件发生率显著低于对照组,差异显著(P<0.05)。结论达比加群应用于房颤PCI术后患者效果显著,其具有良好、稳定的抗凝效果和较为满意的用药安全性,有效减低栓塞及出血事件发生率,值得临床推荐。Objective To investigate the efficacy and safety of dabigatran combined with warfarin anticoagulation after coronary intervention(PCI)in patients with atrial fibrillation.Methods A total of 106 patients with PCI after atrial fibrillation admitted to the Ninth People's Hospital of Zhengzhou City from May 2018 to May 2019 were included in this study.The coin toss method was divided into a control group and an observation group.All received conventional basic treatment including low molecular weight heparin,aspirin,clopidogrel,etc.,53 patients in the control group were treated with warfarin sodium tablets on the conventional basic treatment,and 53 patients in the observation group were treated with dabbi on the conventional basic treatment Treatment with tranexamate capsules,both groups continued treatment for 6 months.After 6 months,the laboratory indicators[platelet count,C-reactive protein,D-dimer,plasma fibrinogen]and coagulation indicators[coagulation]Proenzyme time,thrombin time,activated partial thromboplastin time,prothrombin time international standardized ratio].Results After treatment,the platelet count,C-reactive protein,D-dimer and plasma fibrinogen in the observation group were lower than the control group,the difference was significant(P<0.05);thrombin time and activated partial thromboplastin time in the control group Both are lower than the observation group,the control group's prothrombin time is higher than the observation group,the control group's international normalized ratio of prothrombin time is higher than the observation group,the difference is statistically significant(P<0.05);observation group patients with pulmonary embolism,lower extremity vein The incidence of adverse events such as embolism and hemorrhagic stroke was significantly lower than that of the control group,and the difference was significant(P<0.05).Conclusion Dabigatran is effective in patients with PCI after atrial fibrillation.It has a good and stable anticoagulant effect and relatively satisfactory drug safety.It effect

关 键 词：达比加群酯胶囊 华法林钠片 心房颤动 冠脉介入术 抗凝 

分 类 号：R654[医药卫生—外科学]