口服利伐沙班在脑梗死合并心房颤动患者中抗凝时机的研究  

Anticoagulant Timing of Oral Rivaroxaban in Patients with Cerebral Infarction Complicated with Atrial Fibrillation

作　　者：俞芃 弥娜 王涵 尹娜 YU Peng;MI Na;WANG Han;YIN Na(Dept.of Brain Disease,Beijing Huimin Hospital,Beijing 100053,China)

机构地区：[1]北京市回民医院脑病科,北京100053

出　　处：《中国医院用药评价与分析》2022年第7期796-798,804,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：北京市卫生科技发展专项基金项目(No.2018-2-119)。

摘　　要：目的:探讨口服抗凝血药利伐沙班在脑梗死合并心房颤动患者中抗凝时机的选择,及对患者临床复合血管性事件的影响。方法:选取2019年7月至2020年10月该院收治的脑梗死合并心房颤动患者153例,采用简单随机化法分为A组、B组和C组,各51例。A组患者于脑梗死后<3 d开始抗凝治疗,B组患者于脑梗死后3~14 d开始抗凝治疗,C组患者于脑梗死后>14 d开始抗凝治疗。比较三组患者治疗前后凝血功能指标[凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)和国际标准化比值(INR)]水平;随访6个月,统计三组患者临床复合血管性事件发生率。结果:治疗后,B组患者的TT、APTT和PT长于A组、C组,差异均有统计学意义(P<0.05)。随访6个月,B组患者的临床复合血管性事件发生率为5.88%(3/51),低于A组(23.53%,12/51)、C组(19.61%,10/51),差异均有统计学意义(P<0.05)。结论:脑梗死后3~14 d是脑梗死合并心房颤动患者抗凝治疗的最佳时机,有助于降低临床复合血管性事件发生风险。OBJECTIVE:To probe into the anticoagulant timing of oral anticoagulant rivaroxaban in patients with cerebral infarction complicated with atrial fibrillation and its effects on clinical complex vascular events.METHODS:A total of 153 patients with cerebral infarction complicated with atrial fibrillation admitted into the hospital from Jul.2019 to Oct.2020 were extracted to be divided into group A,B and C by simple randomization,with 51 cases in each group.Anticoagulant therapy was started within 3 d after cerebral infarction in group A,from 3 to 14 d after cerebral infarction in group B,and more than 14 d after cerebral infarction in group C.The coagulation function indicators[thrombin time(TT),activated partial thromboplastin time(APTT),prothrombin time(PT),international normalized ratio(INR)]were compared among three groups before and after treatment.Patients were followed up for 6 months,and the incidence of clinical compound vascular events in three groups was analyzed.RESULTS:After treatment,TT,APTT and PT in group B were longer than those in group A and C,with statistically significant difference(P<0.05).After 6 months of follow-up,the incidence of clinical compound vascular events in group B(5.88%,3/51)was lower than that in group A(23.53%,12/51)and group C(19.61%,10/51),with statistically significant difference(P<0.05).CONCLUSIONS:It is the best time for anticoagulant therapy for patients with cerebral infarction complicated with atrial fibrillation from 3 to 14 d after cerebral infarction,which helps to reduce the risk of clinical compound vascular events.

关 键 词：脑梗死 心房颤动 抗凝时机 凝血功能 临床复合血管性事件 

分 类 号：R973.2[医药卫生—药品]