ABO血型对达比加群酯治疗非瓣膜性房颤效果的影响  

Impact of ABO blood group on the effect of dabigatran etexilate in the treatment of non-valvular atrial fibrillation

作　　者：乔琛琛 梁云龙 QIAO Chenchen;LIANG Yunlong(Department of Cardiology,the First People′s Hospital of Bengbu City of Anhui Province,Bengbu,Anhui,233000)

机构地区：[1]安徽省蚌埠市第一人民医院心血管内科,安徽蚌埠233000

出　　处：《实用临床医药杂志》2023年第23期63-67,共5页Journal of Clinical Medicine in Practice

基　　金：2021年度安徽省蚌埠市第一人民医院医学研究项目(bb1yky2021015)。

摘　　要：目的分析ABO血型不同的非瓣膜性房颤患者应用新型口服抗凝药物达比加群酯治疗前后的凝血功能指标变化情况。方法选取100例非瓣膜性房颤患者作为研究对象,根据血型分为O型组(n=50)和非O型组(n=50),2组均给予达比加群酯胶囊治疗。比较2组患者3个月后凝血功能指标。结果治疗前,2组房颤患者血管性血友病因子(vWF)及蛋白C活性比较,差异有统计学意义(P<0.05);治疗后,2组房颤患者vWF及蛋白C活性比较,差异有统计学意义(P<0.05)。治疗前,2组活化部分凝血活酶时间(APTT)比较,差异无统计学意义(P>0.05),但治疗后2组APTT差异有统计学意义(P<0.05)。治疗前及治疗后,2组间血浆凝血酶原时间(PT)、凝血酶时间(TT)、国际标准化比值(INR)、凝血因子Ⅷ比较,差异均无统计学意义(P>0.05)。2组治疗后所有凝血相关指标与治疗前比较,差异均有统计学意义(P<0.05)。结论O型血患者应用达比加群酯治疗时更应警惕出血事件的发生,并一定程度上可通过APTT和蛋白C活性进行预测。Objective To analyze the changes of coagulation indexes in patients of non-valvular atrial fibrillation with different ABO blood types before and after treatment with the new oral anticoagulant dabigatran etexilate.Methods A total of 100 patients with non-valvular atrial fibrillation were selected as research subjects,and they were divided into type O group(n=50)and non-type O group(n=50)according to blood types,and dabigatran etexilate capsules were given to both groups.The coagulation function indexes of the two groups after 3 months were compared.Results Before treatment,there were significant differences in Von Willebrand factor(vWF)and protein C activities between two groups(P<0.05).After treatment,the activities of vWF and protein C showed significant differences between two groups(P<0.05).Before treatment,there was no significant difference in activated partial thromboplastin time(APTT)between the two groups(P>0.05),but there was a significant difference in APTT between the two groups after treatment(P<0.05).There were no significant between-group differences in plasma prothrombin time(PT),thrombin time(TT),international normalized ratio(INR)and coagulation factorⅧbefore and after treatment(P>0.05).There were significant differences in all coagulation related indexes between the two groups after treatment compared with treatment before(P<0.05).Conclusion Patients with type O blood are more likely to alert to occurrence of bleeding events when treated with dabigatran etexilate,and can be predicted by APTT and protein C activity to some extent.

关 键 词：心房颤动 达比加群酯 ABO血型 凝血因子 蛋白C活性 血管性血友病因子 

分 类 号：R453[医药卫生—治疗学] R541.7[医药卫生—临床医学] R364.1