利伐沙班与达比加群酯在高龄非瓣膜病性房颤患者长期抗凝治疗的疗效及安全性  

Curative effect and safety of rivaroxaban and dabigatran in long-term anticoagulation treatment in elderly patients with non-valvular atrial fibrillation

作　　者：陈艳梅 武云涛 刘立新[1] Chen Yanmei;Wu Yuntao;Liu Lixin(Department of Geriatrics,Seventh Medical Center of Chinese PLA General Hospital,Beijing 100700,China;不详)

机构地区：[1]解放军总医院第七医学中心老年医学科,北京100700

出　　处：《中国循证心血管医学杂志》2020年第9期1059-1061,1066,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：军队保健专项科研课题(15BJZ03)。

摘　　要：目的观察长期应用利伐沙班与达比加群酯在高龄非瓣膜病性房颤(NVAF)患者抗凝治疗的有效性及安全性。方法入选2016年1月至2018年1月于解放军总医院第七医学中心老年医学科住院和门诊就诊,年龄≥80岁的男性NVAF患者,根据口服不同抗凝药物分为2组。利伐沙班组88例,年龄80~96岁,平均年龄(87.20±3.05)岁;达比加群酯组86例,年龄81~94岁,平均年龄(86.5±2.07)岁。比较2组患者不良反应的发生情况。结果服药后随访1年,达比加群酯组患者发生脑梗死1例,利伐沙班组无脑梗死病例,2组患者药物有效性无明显差异(P>0.05)。利伐沙班组出血15例,达比加群酯组13例,其中利伐沙班组发生气管内大出血1例,达比加群酯组无大出血发生,其他出血2组均为轻度非致命性出血,2组药物安全性方面比较无明显统计学差异(P>0.05)。结论严密监测皮肤粘膜出血情况下,对于高龄老年NVAF患者应用适当剂量的利伐沙班和达比加群酯抗凝治疗是安全有效的。Objective To observe the efficacy and safety of rivaroxaban and dabigatran in long-term anticoagulation treatment in elderly patients with non-valvular atrial fibrillation(NVAF).Methods NVAF patients(aged≥80)were chosen from Department of Geriatrics of the Seventh Medical Center of Chinese PLA General Hospital from Jan.2016 to Jan.2018,and divided into 2 groups according to different administration of anticoagulants,including rivaroxaban group(n=88,aged from 80 to 96 and average age=87.20±3.05)and dabigatran group(n=86,aged from 81 to 94 and average age=86.5±2.07).The incidence of adverse reactions was compared between 2 groups.Results After followed up for 1 y after treatment,there were 1 case of cerebral infarction in dabigatran group and no case of cerebral infarction in rivaroxaban group.The efficacy of drugs had no significant difference between 2 groups(P>0.05).There were 15 cases of bleeding in rivaroxaban group and 13 cases of bleeding in dabigatran group.There was 1 case of massive hemorrhage in trachea in rivaroxaban group and no case in dabigatran group.The other bleeding events were all mile nonfatal bleeding.The safety of drugs had no significant difference between 2 groups(P>0.05).Conclusion Under monitoring closely mucocutaneous hemorrhage,rivaroxaban and dabigatran in proper doses are safe and effective in elderly NVAF patients.

关 键 词：非瓣膜性心房颤动 利伐沙班 达比加群酯 高龄 

分 类 号：R541.75[医药卫生—心血管疾病]