心房颤动合并冠心病冠状动脉介入治疗术后抗凝方法及效果探究  

Study on anticoagulation methods and effects after coronary intervention for atrial fibrillation complicated with coronary heart disease

作　　者：吴羿颖 邢芸芸[1] 王心悦[1] 张木[1] WU Yiying;XING Yunyun;WANG Xinyue;ZHANG Mu(Department of CCU,Shenyang Fourth People's Hospital,Shenyang,Liaoning,110031,China)

机构地区：[1]沈阳市第四人民医院CCU,辽宁沈阳110031

出　　处：《当代医学》2021年第28期72-74,共3页Contemporary Medicine

摘　　要：目的探讨心房颤动合并冠心病冠状动脉介入治疗术后抗凝方法及效果。方法回顾性分析2016年1月至2018年12月本院收治的80例心房颤动合并冠心病患者的临床资料,根据冠状动脉介入治疗术后抗凝治疗方法的不同分为对照组和观察组,每组40例。对照组给予阿司匹林和氯吡格雷抗凝治疗,观察组在对照组基础上给予利伐沙班治疗。比较两组术后血小板计数、血红蛋白水平、左心室射血分数、谷丙转氨酶(ALT)水平、谷草转氨酶(AST)水平、术后不良心血管事件发生率及术后出血事件发生率。结果两组术后血小板计数、血红蛋白水平、左心室射血分数、ALT以及AST水平比较差异无统计学意义;观察组术后不良心血管事件发生率低于对照组,术后出血事件发生率高于对照组,差异有统计学意义(P<0.05)。结论心房颤动合并冠心病冠状动脉介入治疗患者采用阿司匹林和氯吡格雷联合利伐沙班抗凝治疗可更好地减少不良心血管事件的发生,但同时也增加了出血风险,临床应根据患者的实际情况选择适宜的抗凝方法。Objective To investigate the anticoagulation method and effect after coronary intervention for atrial fibrillation complicated with cor-onary heart disease.Methods The clinical data of 80 patients with atrial fibrillation complicated with coronary heart disease treated in our hospital from January 2016 to December 2018 were retrospectively analyzed.According to the different methods of anticoagulation treatment after coronary intervention,they were divided into control group and observation group,with 40 cases in each group.The control group was given aspirin and clopi-dogrel anticoagulant therapy,and the observation group was given rivaroxaban on the basis of the control group.The postoperative platelet count,he-moglobin level,left ventricular ejection fraction,alanine aminotransferase(ALT)level,aspartate aminotransferase(AST)level,the incidence of post-operative adverse cardiovascular events and the incidence of postoperative bleeding events were compared between the two groups.Results There was no significant difference in postoperative platelet count,hemoglobin level,left ventricular ejection fraction,ALT and AST levels between the two groups.The incidence of adverse cardiovascular events in the observation group was lower than that in the control group,and the incidence of postop-erative bleeding events was higher than the control group,the difference was statistically significant(P<0.05).Conclusion The anticoagulation therapy of aspirin and clopidogrel anticoagulation combined with rivaroxaban anticoagulation for patients with atrial fibrillation and coronary heart disease after coronary intervention can better reduce the occurrence of adverse cardiovascular events,but it also increases the risk of bleeding.The ap-propriate anticoagulation method should be selected according to the actual situation of patient.

关 键 词：心房颤动合并冠心病 冠状动脉介入治疗 术后抗凝方法 

分 类 号：R541.75[医药卫生—心血管疾病] R541.4[医药卫生—内科学]