阿哌沙班联合双联抗血小板对冠心病合并房颤患者生存质量、心功能及miR-146水平的影响  

Effect of apixaban combined with dual antiplatelet on quality of survival,cardiac function and miR-146 levels in patients with coronary artery disease combined with atrial fibrillation

作　　者：崔萍[1] 郭晨贤 单维新 王继伟[1] 蒋超鹏[1] 石桂良 CUI Ping;GUO Chen-xian;SHAN Wei-xin;WANG Ji-wei;JIANG Chao-peng;SHI Gui-liang(Department of Cardiovascular Medicine,Wujin Hospital of Traditional Chinese Medicine,Wujin Affiliated Hospital of University of Chinese Medicine,Changzhou 213161,Jiangsu,China)

机构地区：[1]常州市武进中医医院·南京中医药大学武进附属医院心血管病科,江苏常州213161

出　　处：《川北医学院学报》2024年第10期1378-1381,共4页Journal of North Sichuan Medical College

基　　金：江苏省常州市科技项目(CJ20230009)。

摘　　要：目的:探讨阿哌沙班联合双联抗血小板治疗对冠心病合并房颤患者生存质量、心功能及miR-146水平的影响。方法:选取92例冠心病合并房颤患者作为研究对象,依据治疗方式将患者分为对照组(华法林联合双联抗血小板治疗,n=46)和观察组(阿哌沙班联合双联抗血小板治疗,n=46),所有患者均连续治疗3个月。比较两组患者的临床疗效、生存质量、心功能、凝血功能、炎症指标及miR-146水平,并记录不良反应发生情况。结果:观察组治疗有效率高于对照组(91.30%vs.76.09%,P<0.05);治疗后,观察组SF-36评分高于对照组[(83.57±6.37)vs.(76.48±6.14),P<0.001],MLWHFQ评分低于对照组[(32.13±4.90)vs.(37.20±5.40),P<0.001];观察组LVEF水平高于对照组[(55.38±6.92)vs.(51.23±6.74),P<0.05];观察组PT、TT及APTT水平均高于对照组(P<0.001);观察组MCP-1、CRP及miR-146水平均低于对照组(P<0.05);观察组出血发生率及不良反应总发生率均低于对照组(P<0.05)。结论:采用阿哌沙班联合双联抗血小板治疗冠心病合并房颤的疗效确切,利于改善患者心功能及凝血功能,并可降低炎症反应程度及出血等不良事件发生风险,有助于提高患者生存质量。Objective:To investigate the effects of apixaban combined with dual antiplatelet therapy on quality of survival,cardiac function,and miR-146 levels in patients with coronary artery disease combined with atrial fibrillation.Methods:92 patients with CHD and AF were divided into a control group(warfarin combined with dual antiplatelet therapy,n=46)and an observation group(apixaban combined with dual antiplatelet therapy,n=46)based on the different treatment methods.Both groups were treated for three months.Clinical efficacy,quality of life,cardiac function,coagulation function,inflammation indicators,and miR-146 levels were compared between the two groups.Adverse reactions were also recorded.Results:The treatment efficacy in the observation group was higher than in the control group(91.30%vs.76.09%,P<0.05).Post-treatment,the observation group had higher SF-36 scores and lower MLWHFQ scores compared to the control group[(83.57±6.37)vs.(76.48±6.14),P<0.001,(32.13±4.90)vs.(37.20±5.40),P<0.001].The LVEF level in the observation group was higher than in the control group[(55.38±6.92)vs.(51.23±6.74),P<0.05].The PT,TT,and APTT levels in the observation group were higher than those in the control group(P<0.001).The levels of MCP-1,CRP,and miR-146 in the observation group were lower than those in the control group(P<0.05).The incidence of bleeding and total adverse reactions in the observation group were lower than those in the control group(P<0.05).Conclusion:The use of apixaban combined with dual antiplatelet therapy for the treatment of coronary artery disease combined with atrial fibrillation has a definite efficacy,which is conducive to the improvement of cardiac function and coagulation function of patients,and can reduce the degree of inflammatory response and the risk of adverse events such as hemorrhage,which contributes to the improvement of the quality of survival of patients.

关 键 词：阿哌沙班 双联抗血小板 冠心病 心房颤动 

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