高龄非瓣膜性房颤患者应用不同抗凝药物治疗的效果分析  

Analysis on the effect of different anticoagulant drugs in the treatment of elderly patients with nonvalvular atrial fibrillation

作　　者：王杏杰 褚凤叶 周丽君 舒苗 徐欢 WANG Xing-jie;CHU Feng-ye;ZHOU Li-jun(General Department,Community Health Service Center,Shihudang Town,Songjiang District,Shanghai 201604,China)

机构地区：[1]上海市松江区石湖荡镇社区卫生服务中心全科,201604

出　　处：《中国实用医药》2025年第3期89-91,共3页China Practical Medicine

摘　　要：目的分析不同抗凝药物对高龄非瓣膜性心房颤动(房颤)患者的治疗效果。方法180例高龄非瓣膜性房颤患者,随机分为A组、B组、C组,各60例。A组通过达比加群酯进行抗凝治疗,B组通过华法林进行抗凝治疗,C组通过利伐沙班进行抗凝治疗。对比三组患者凝血指标[凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)、凝血酶原时间-国际标准化比值(PT-INR)]及不良事件发生情况。结果治疗后,A组患者PT(12.07±3.18)s、TT(16.34±4.25)s、FIB(3.01±1.33)g/L、PT-INR(2.35±0.18)均优于B组的(10.22±2.71)s、(14.61±4.19)s、(4.08±1.24)g/L、(3.44±0.32)和C组的(10.25±2.65)s、(14.58±4.22)s、(4.02±1.21)g/L、(3.51±0.33)(P<0.05)。A组患者出血发生率1.67%以及栓塞发生率3.33%均明显低于B组的25.00%、20.00%和C组的20.00%、20.00%(P<0.05)。结论高龄非瓣膜性房颤患者通过达比加群酯抗凝治疗,可有效改善凝血指标,降低出血及栓塞发生率,值得在临床上应用推广。Objective To analyze the effect of different anticoagulant drugs in the treatment of elderly patients with nonvalvular atrial fibrillation.Methods 180 elderly patients with nonvalvular atrial fibrillation were randomly divided into group A,group B and group C,each with 60 cases.Group A received anticoagulant therapy with dabigatran,group B received anticoagulant therapy with warfarin,and group C received anticoagulant therapy with rivaroxaban tablets.The coagulation index[prothrombin time(PT),thrombin time(TT),fibrinogen(FIB),PT-International Normalized ratio(PT-INR)]and the occurrence of adverse events were compared among the three groups.Results After treatment,group A had PT of(12.07±3.18)s,TT of(16.34±4.25)s,FIB of(3.01±1.33)g/L and PT-INR of(2.35±0.18),which were better than those in group B[(10.22±2.71)s,(14.61±4.19)s,(4.08±1.24)g/L and(3.44±0.32)]and group C[(10.25±2.65)s,(14.58±4.22)s,(4.02±1.21)g/L and(3.51±0.33)](P<0.05).The incidence of bleeding and embolism were 1.67%and 3.33%in group A,which were significantly lower than 25.00%and 20.00%in group B,and 20.00%and 20.00%in group C(P<0.05).Conclusion In the treatment of elderly patients with nonvalvular atrial fibrillation,anticoagulation therapy with dabigatran etexilate can effectively improve the coagulation index and reduce the incidence of bleeding and embolism,which is worthy of clinical application and promotion.

关 键 词：高龄 非瓣膜性心房颤动 华法林 达比加群酯 利伐沙班 

分 类 号：R541.75[医药卫生—心血管疾病]