心房颤动合并冠心病行冠脉介入治疗两种不同抗凝方法的安全性比较  

Comparison on Safety of Two Different Anticoagulant Methods for Atrial Fibrillation Combined with Coronary Heart Disease

作　　者：罗剑静 梁国泉 陆水英[1] 刘琳 许碧夏[1] 邓舒妮[1] LUO Jian jing;LIANG Guo quan;LU Shui ying;LIU Lin;XU Bi xia;DENG Shu ni(Department of Internal Medicine,Zhaoqing Medical College,Zhaoqing,Guangdong Province,526000 China;Department of Cardiology,Zhaoqing Second People's Hospital,Zhaoqing,Guangdong Province,526000 China)

机构地区：[1]肇庆医学高等专科学校内科,广东肇庆526000 [2]肇庆市第二人民医院心内科,广东肇庆526000

出　　处：《中外医疗》2022年第33期48-51,共4页China & Foreign Medical Treatment

基　　金：肇庆市科学技术局2020(202004030717)。

摘　　要：目的探究比较心房颤动合并冠心病行冠脉介入治疗两种不同抗凝方法的安全性。方法采用随机数表法将2020年8月-2021年8月在肇庆市第二人民医院治疗的98例心房颤动合并冠心病行经皮冠状动脉介入术(percutaneous coronary intervention,PCI)且服用华法林抗凝治疗的患者分为对照组和观察组,每组49例。对照组行桥接抗凝,观察组维持华法林抗凝治疗。比较两组治疗前后实验室指标及心血管不良事件发生率。结果治疗后3、6、12个月,观察组患者PLT、CRP、FIB、D-D水平均低于对照组,差异有统计学意义(P<0.05);观察组心血管不良事件发生率(6.12%)低于对照组(20.41%),差异有统计学意义(χ^(2)=4.346,P<0.05)。结论与桥接治疗相比,对心房颤动合并冠心病行冠脉介入治疗患者行维持华法林治疗可明显降低实验室各项指标水平及心血管不良事件发生率,具有临床价值。Objective To explore and compare the safety of two different anticoagulation methods for atrial fibrillation combined with coronary heart disease.Methods 98 cases of atrial fibrillation combined with coronary heart disease treated in Zhaoqing Second People's Hospital from August 2020 to August 2021 were treated with percutaneous coronary intervention(PCI),and took warfarin anticoagulant therapy,which were divided into control group and observation group by random number table method,49 cases in each group.The control group received bridging anticoagulant therapy,and the observation group maintained warfarin anticoagulant therapy.The laboratory indexes and the incidence of cardiovascular adverse events before and after treatment were compared between the two groups.Results At 3,6 and 12 months after treatment,the levels of PLT,CRP,FIB and D-D in observation group were lower than those in control group,the difference was statistically significant(P<0.05).The incidence of cardiovascular adverse events in the observation group(6.12%)was lower than that in the control group(20.41%),and the difference was statistically significant(χ^(2)=4.346,P<0.05).Conclusion Compared with bridging therapy,warfarin maintenance therapy can significantly reduce the level of laboratory indicators and the incidence of cardiovascular adverse events in patients with atrial fibrillation and coronary heart disease undergoing coronary interventional therapy,which has clinical value.

关 键 词：心房颤动 冠心病 冠脉介入治疗 抗凝 

分 类 号：R541[医药卫生—心血管疾病]