不同强度利伐沙班抗凝治疗在老年稳定型冠心病合并非瓣膜性心房颤动中的应用效果  

Application effect of different intensity rivaroxaban anticoagulation therapy in elderly patients with stable coronary heart disease complicated with non-valvular atrial fibrillation

作　　者：韩莹璐 薛晓燕 刘欣[2] HAN Yinglu;XUE Xiaoyan;LIU Xin(No.1 Internal Medicine Department,the People's Hospital of Zichang,Yan'an 717300;Cardiovascular Internal Medicine Department,Yulin Hospital,the First Affiliated Hospital of Xi'an Jiaotong University,Yulin 719000,China)

机构地区：[1]子长市人民医院内一科,陕西延安717300 [2]西安交通大学第一附属医院榆林医院心血管内科,陕西榆林719000

出　　处：《临床医学研究与实践》2024年第36期70-73,共4页Clinical Research and Practice

摘　　要：目的分析不同强度利伐沙班抗凝治疗在老年稳定型冠心病合并非瓣膜性心房颤动中的应用效果。方法选取2021年1月至2022年1月收治的120例老年稳定型冠心病合并非瓣膜性心房颤动患者为研究对象,根据给药剂量不同将其分为低剂量组(n=40,10 mg利伐沙班)、中剂量组(n=40,15 mg利伐沙班)和高剂量组(n=40,20 mg利伐沙班)。比较三组的凝血功能、主要心血管不良事件(MACE)发生情况、出血情况及不良反应发生情况。结果治疗后,三组的凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)均延长,国际标准化比值(INR)均升高(P<0.05);治疗后,三组的PT、TT、APTT及INR比较,差异无统计学意义(P>0.05)。三组的MACE总发生率比较,差异无统计学意义(P>0.05)。三组的出血总发生率比较,差异具有统计学意义(P<0.05)。三组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论不同强度利伐沙班抗凝治疗在老年稳定型冠心病合并非瓣膜性心房颤动患者中均有较好的应用效果,其中高剂量利伐沙班的抗凝作用更明显,但容易导致出血倾向,故更推荐采用低剂量利伐沙班。Objective To analyze the application effect of different intensity rivaroxaban anticoagulation therapy in elderly patients with stable coronary heart disease complicated with non-valvular atrial fibrillation.Methods A total of 120 elderly patients with stable coronary heart disease complicated with non-valvular atrial fibrillation admitted from January 2021 to January 2022 were selected as the study objects.According to the different doses of administration,the patients were divided into low-dose group(n=40,10 mg rivaroxaban),middle-dose group(n=40,15 mg rivaroxaban)and high-dose group(n=40,20 mg rivaroxaban).The coagulation function,major adverse cardiac events(MACE),bleeding and adverse reactions were compared among the three groups.Results After treatment,the prothrombin time(PT),thrombin time(TT)and activated partial thromboplastin time(APTT)of the three groups were prolonged,and the international normalized ratio(INR)was increased(P<0.05);after treatment,there were no significant differences in PT,TT,APTT and INR among the three groups(P>0.05).There was no significant difference in the total incidence of MACE among the three groups(P>0.05).There was a statistically significant difference in the total incidence of bleeding among the three groups(P<0.05).There was no significant difference in the total incidence of adverse reactions among the three groups(P>0.05).Conclusion Different intensity rivaroxaban anticoagulant therapy in elderly patients with stable coronary heart disease complicated with non-valvular atrial fibrillation has a good application effect,and the anticoagulant effect of high-dose rivaroxaban is more obvious,but it is easy to lead to bleeding tendency,so it is more recommended to use low-dose rivaroxaban.

关 键 词：老年 稳定型冠心病 非瓣膜性心房颤动 抗凝治疗 利伐沙班 

分 类 号：R541.75[医药卫生—心血管疾病]