新型抗凝药物对老年阵发性心房颤动病人卒中及认知障碍的预防效果  

Prophylactic effects of novel anticoagulants on stroke and cognitive impairment in elderly patients with paroxysmal atrial fibrillation

作　　者：薛志会 李蕊 XUE Zhi-hui;LI Rui(Department of Cardiology,Sanhe Hospital of Hebei,Sanhe Hebei 065200,China)

机构地区：[1]河北省三河市医院心内科,065200

出　　处：《蚌埠医学院学报》2020年第10期1399-1402,共4页Journal of Bengbu Medical College

摘　　要：目的:探讨新型抗凝药物对阵发性心房颤动(房颤)病人发生卒中及认知障碍的预防效果。方法:选择阵发性老年房颤病人646例为研究对象。依据病人使用的抗凝治疗药物分为凝血因子Xa抑制剂组318例(A组)、凝血因子Ⅱa抑制剂组145例(B组)及华法林组183例(C组)。前瞻性观察病人卒中、认知障碍等事件的发生情况,采用简易精神状态检查表(MMSE)评价病人认知功能。结果:3组病人随访24个月内的卒中、出血发生率、死亡率差异均无统计学意义(P>0.05)。基线、抗凝治疗6个月与12个月后3组病人轻度及以上认知障碍发生率、MMSE评分差异均无统计学意义(P>0.05);抗凝治疗24个月复测结果显示,A、B、C组轻度及以上认知障碍发生率分别为14.7%、15.7%与24.4%,MMSE评分分别为(27.45±3.28)(27.26±3.14)与(26.13±3.54)分,A、B组均高于C组(P<0.05)。结论:新型抗凝药物对房颤相关卒中具有较好效果与安全性,可能会对房颤病人长期认知障碍的预防有积极作用。Objective:To investigate the prophylactic effects of novel anticoagulants on stroke and cognitive impairment in elderly patients with paroxysmal atrial fibrillation.Methods:A total of 646 elderly patients with paroxysmal atrial fibrillation were divided into the coagulation factor Xa inhibitor group(n=318,group A),coagulation factorⅡainhibitor group(n=145,group B)and warfarin group(n=183,group C)according to the used anticoagulant.In three groups,the incidence of stroke,cognitive impairment and other events were prospectively analyzed,and the cognitive function was evaluated using the mini-mental status examination(MMSE).Results:The differences of the incidence rates of stroke,bleeding and mortality among three groups were not statistically significant during 24 months of following-up(P>0.05).The differences of the incidence rates of mild cognitive impairment and MMSE scores among three groups were not statistically significant at baseline and after 6 months and 12 months of anticoagulant therapy(P>0.05).The retest results after 24 months of anticoagulant therapy showed that the incidence rates of mild and above cognitive impairment,and MMSE scores in A,B and C group were(14.7%,15.7%and 24.4%)and[(27.45±3.28),(27.26±3.14)and(26.13±3.54)],respectively.The differences in the incidence rates of cognitive impairment and MMSE score among three groups were statistically significant(P<0.05).Conclusions:The novel anticoagulant have good efficacy and safety in atrial fibrillation-related stroke,and may play a positive role in the prevention of cognitive impairment in patients with atrial fibrillation.

关 键 词：阵发性心房颤动 新型抗凝药物 卒中 认知障碍 

分 类 号：R541.75[医药卫生—心血管疾病]