利伐沙班、达比加群酯在冠心病合并房颤患者冠脉支架植入术后应用的疗效对比  

Comparison of Therapeutic Effects between Rivaroxaban and Dabigatran on Patients with Coronary Heart Disease and Atrial Fibrillation after Coronary Stent Implantation

作　　者：叶保勇 万雪永 叶保梅 YE Baoyong;WAN Xueyong;YE Baomei(Cardiovascular Medicine,the Second People's Hospital of Jingdezhen,Jingdezhen 333000,China)

机构地区：[1]景德镇市第二人民医院心血管内科,江西景德镇333000

出　　处：《中国医学创新》2024年第24期64-68,共5页Medical Innovation of China

摘　　要：目的:观察冠心病合并房颤患者冠脉支架植入术后应用利伐沙班、达比加群酯的效果。方法:选取2021年6月—2023年6月景德镇市第二人民医院收治的80例行冠脉支架植入术治疗的冠心病合并房颤患者,随机分为两组,各40例。两组术后均予以氯吡格雷,在此基础上,A组给予利伐沙班,B组给予达比加群酯。比较两组治疗前后凝血功能[纤维蛋白原(FIB)、凝血酶原时间(PT)、血小板计数(PLT)与D-二聚体(D-D)]、炎症因子[超敏C反应蛋白(hs-CRP)]、出血事件、心脑血管不良事件、不良反应发生率及住院时间。结果:治疗前,两组FIB、PT、PLT、D-D及hs-CRP比较,差异均无统计学意义(P>0.05);治疗后,两组FIB、PT、PLT、D-D及hs-CRP均低于治疗前,差异均有统计学意义(P<0.05),但两组间比较,差异均无统计学意义(P>0.05)。两组出血事件、心脑血管不良事件、药物不良反应总发生率及住院时间比较,差异均无统计学意义(P>0.05)。结论:冠心病合并房颤患者冠脉支架植入术后应用利伐沙班或者达比加群酯均可有效改善机体凝血功能及炎症状态,效果及安全性相当。Objective:To observe the effects of Rivaroxaban and Dabigatran in patients with coronary heart disease and atrial fibrillation after coronary stent implantation.Method:A total of 80 patients with coronary heart disease and atrial fibrillation who underwent coronary stent implantation in the Second People's Hospital of Jingdezhen from June 2021 to June 2023 were selected and randomly divided into two groups,with 40 cases in each group.Two groups were treated with Clopidogrel after operation,on this basis,group A was treated with Rivaroxaban and group B was treated with Dabigatran.The coagulation function[fibrinogen(FIB),prothrombin time(PT),platelet count(PLT)and D-dimer(D-D)],inflammatory factors[hypersensitive C reactive protein(hs-CRP)]before and after treatment,incidences of bleeding events,cardiovascular and cerebrovascular adverse events,adverse drug reactions and length of hospital stay were compared between the two groups.Result:Before treatment,there were no statistically significant differences in FIB,PT,PLT,D-D and hs-CRP between the two groups(P>0.05).After treatment,FIB,PT,PLT,D-D and hs-CRP in the two groups were lower than those before treatment,with statistically significant differences(P<0.05),but there were no statistically significant differences between the two groups(P>0.05).There were no statistically significant differences in the total incidences of bleeding events,cardiovascular and cerebrovascular adverse events,adverse drug reactions and hospital stay between the two groups(P>0.05).Conclusion:The application of Rivaroxaban or Dabigatran in patients with coronary heart disease and atrial fibrillation after coronary stent implantation can effectively improve coagulation function and inflammatory state,with comparable effects and safety.

关 键 词：新型口服抗凝药 冠心病 房颤 冠脉支架植入术 

分 类 号：R541.4[医药卫生—心血管疾病] R541.75[医药卫生—内科学]