达比加群酯治疗老年非瓣膜性心房颤动的有效性和安全性评价  

Efficacy and safety evaluation of dabigatran etexilate in the treatment of elderly non-valvular atrial fibrillation

作　　者：李婷 时扣荣[2] 李智[3] 王子玉[4] 曹爱霖 钱皎 LI Ting;SHI Kourong;LI Zhi;WANG Ziyu;CAO Ailin;QIAN Jiao(Department of Pharmacy,the First Affiliated Hospital of Naval Medical University,Shanghai 200433,China;Department of Pharmacy,the Seventh People's Hospital of Shanghai University of TCM,Shanghai 200137,China;Department of Pharmacy,the First Hospital of Lianyungang,Lianyungang 222000,China;Department of Pharmacy,Huadong Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]海军军医大学第一附属医院药学部,上海200433 [2]上海中医药大学附属第七人民医院药学部,上海200137 [3]连云港市第一人民医院药学部,江苏连云港222000 [4]复旦大学附属华东医院药剂科,上海200040

出　　处：《药学实践与服务》2023年第9期557-560,共4页Journal of Pharmaceutical Practice and Service

基　　金：2019年上海市“医苑新星”青年医学人才培养资助计划;白求恩·医学科学研究基金资助项目(AE020CS)。

摘　　要：目的探讨达比加群酯治疗老年非瓣膜性心房颤动的有效性和安全性,为临床治疗和合理用药提供参考。方法采用自身对照的研究方法,收集2020年12月-2021年6月在上海市第七人民医院住院或门诊的老年非瓣膜性房颤患者80例,年龄65~80岁。给予口服达比加群酯胶囊110 mg/次,每天2次(早、晚各1次),治疗6个月。随访,观察服药1个月、6个月后患者的凝血功能指标,包括活化部分凝血活酶时间(APTT)、血浆凝血酶时间(TT)、纤维蛋白原(FIB)和D-二聚体(D-D);肝功能指标,包括丙氨酸氨基转移酶(ALT)、谷草转氨酶(AST)和总胆红素(TBIL),肾功能指标,包括尿素(UREA)和肾小球滤过率估计值(eGFR);血常规指标,包括血红蛋白量(HGB)和红细胞沉降率(ESR)。结果患者服用达比加群酯治疗1个月、6个月后与服药前比较:APTT、TT均有升高,差异有统计学意义(P<0.05);肝功能指标、肾功能指标、血常规指标差异无统计学意义(P>0.05);共发生25例不良事件,不良事件发生率为31.25%,并未发生严重出血和威胁生命或器官衰竭的出血。结论达比加群酯在治疗老年非瓣膜性心房颤动方面,有较好的疗效和安全性。Objective To explore the efficacy and safety of dabigatran etexilate in the treatment of elderly patients with non-valvular atrial fibrillation(NVAF),so as to provide reference for clinical treatment and rational drug use.Methods Eighty elderly patients with NVAF in The Seventh People's Hospital of Shanghai from December 2020 to June 2021,aged 65 to 80 years,were enrolled in a self-controlled study.Dabigatran etexilate 110 mg was given orally,twice a day(one in the morning and one in the evening)for 6 months.During the follow-up visit,the coagulation function indexes including APTT,TT,FIB and D-D were observed in patients taking medicine for 1 month and 6 months.Liver function indexes including ALT,AST and TBIL,renal function indicators including UREA and eGFR,and blood routine indexes including HGB and ESR,also were observed in patients taking medicine for 1 month and 6 months.Results Patients were compared at 1 month and 6 months after treatment with dabigatran and before:the difference of coagulation function indexes as APTT and TT was statistically significant(P<0.05);There was no significant difference in liver function index,renal function index and blood routine index(P>0.05);A total of 25 adverse events occurred,and the incidence rate of adverse reactions was 31.25%,there was no adverse events such as serious hemorrhage,life threatening and organ failure hemorrhage occurred.Conclusion Dabigatran has good efficacy and safety in the treatment of the elderly NVAF.

关 键 词：达比加群酯 非瓣膜性心房颤动 有效性 安全性 

分 类 号：R541.75[医药卫生—心血管疾病]