低剂量达比加群酯对NVAF合并轻中度慢性肾损害患者的影响  

Effect of low dose dabigatran on NVAF patients with mild to moderate chronic kidney injury

作　　者：耿艳芳 程栋[2] 李素珍[2] Geng yanfang;Cheng dong;Li suzhen(Department of Cardiology,Tangyin County People's Hospital,Tangyin,Henan,456150,China;Department of Cardiology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan,450052,China.)

机构地区：[1]河南省汤阴县人民医院,456150 [2]郑州大学第一附属医院,450052

出　　处：《临床心电学杂志》2022年第1期42-45,共4页Journal of Clinical Electrocardiology

摘　　要：目的分析高龄非瓣膜性心房颤动(NVAF)合并轻中度慢性肾损害患者应用低剂量达比加群酯对终点事件发生率、血管内皮及凝血功能的影响。方法选取我科2018年1月至2020年10月期间121例高龄非瓣膜性心房颤动合并轻中度慢性肾损害患者作为研究对象,采用随机数字表法进行分组,对照组60例给予华法林,观察组61例给予低剂量达比加群酯,对比两组患者血管内皮功能、凝血功能、血生化指标、栓塞或血栓形成及出血事件的发生率。结果治疗6个月后,观察组和对照组谷丙转氨酶、空腹血糖、甘油三脂、肌酐及胆红素水平与治疗前比较,无统计学差异(p>0.05)治疗6个月后,观察组患者CEC及ET-1评分低于对照组(p<0.05);PT、TT、FIB及APTT水平高于对照组(p<0.05);观察组血栓栓塞发生事件与对照组比较,无统计学差异(p>0.05),观察组出血事件低于对照组(p<0.05)。结论小剂量达比加群酯治疗NFAF合并中轻度慢性肾损害患者效果显著,安全性高,可降低出血事件发生的风险,改善凝血功能,有利于减少血管内皮的损伤。Objective To analyze the effects of low-dose dabigatran on the incidence of end-point events,vascular endothelial and coagulation function in elderly patients with NVAF complicated with mild to moderate chronic kidney injury.Methods Total 121 elderly patients enrolled into our department between January 2018 to October 2020 who had nonvalvular atrial fibrillation with mild-to-moderate chronic renal damage 60 cases were treated with warfarin,the observation group 61 patients were given low doses of dabigatrun.We compared the two groups of patients with vascular endothelial function,blood coagulation function,blood biochemical indices,incidence of embolism or thrombosis,and bleeding events.Results After 6 months of treatment,there were no significant differences in alanine aminotransferase,fasting blood glucose,TC,creatinine and bilirubin levels between the observation group and the control group(p>0.05).After 6 months of treatment,CEC and ET-1 scores in the observation group were lower than those in the control group(p<0.05).PT,TT,FIB and APTT levels were higher than those in control group(p<0.05).There was no significant difference in the incidence of thromboembolism between the observation group and the control group(p>0.05),and the bleeding events in the observation group were lower than those in the control group(p<0.05).Conclusions Low dose of dabigatrun in the treatment of NFAF patients with moderate to mild chronic renal injury has a significant effect,high safety,can reduce the risk of bleeding events,improve the coagulation function,is beneficial to reduce the injury of vascular endothelial.

关 键 词：低剂量达比加群酯 终点事件发生率 血管内皮功能 凝血功能 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]