利伐沙班用于高龄心房颤动患者抗凝治疗的有效性和安全性研究  

Efficacy and safety of rivaroxaban for anticoagulant therapy in elderly patients with atrial fibrillation

作　　者：兰艳纤[1] 陆海鹏[1] 吕聪[1] 曾雨歆 罗秀[1] LAN Yanxian;LU Haipeng;LYU Cong;ZENG Yuxin;LUO Xiu(Department of Pharmacy,Minzu Hospital of Guangxi Zhuang Autonomous Region,Affiliated Minzu Hospital of Guangxi Medical University,Nanning 530001,Guangxi,China)

机构地区：[1]广西壮族自治区民族医院/广西医科大学附属民族医院药学部,广西南宁530001

出　　处：《中国现代医生》2025年第7期59-62,共4页China Modern Doctor

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z-F20221767)。

摘　　要：目的评估利伐沙班在高龄心房颤动患者中应用的有效性和安全性。方法回顾性分析2022年7月至2023年9月于广西壮族自治区民族医院住院的236例高龄心房颤动患者的临床资料,根据使用抗凝药物的不同将其分为利伐沙班组(148例)和华法林组(88例)。对比分析两组患者的新发血栓、出血事件及全因死亡。采用Logistic回归与多因素Cox回归分析探讨新发血栓、出血、全因死亡的影响因素。结果利伐沙班组患者使用抗血小板药物比例、血小板计数均显著高于华法林组,凝血酶时间、凝血酶原时间、国际标准化比值均显著低于华法林组(P<0.05)。校正混杂因素前后,两组患者的新发血栓、出血事件及全因死亡风险比较差异均无统计学意义(P>0.05)。多因素Cox回归分析结果显示合并使用非甾体抗炎药、应用低剂量利伐沙班均是高龄心房颤动患者死亡的危险因素(P<0.05)。结论利伐沙班对高龄心房颤动患者的有效性和安全性不劣于华法林。Objective To evaluate the efficacy and safety of rivaroxaban in elderly patients with atrial fibrillation.Methods The cases datas of 236 elderly patients with atrial fibrillation hospitalized in Minzu Hospital of Guangxi Zhuang Autonomous Region from July 2022 to September 2023 were retrospectively analyzed.According to the use of anticoagulant drugs,they were divided into rivaroxaban group(148 cases)and warfarin group(88 cases).New thrombosis,bleeding events and all-cause death during hospitalization were compared between two groups.Logistic regression and multi-factor Cox regression analysis were used to investigate the influencing factors of new thrombus,hemorrhage and all-cause death.Results The proportion of antiplatelet drugs and platelet count in rivaroxaban group were significantly higher than those in warfarin group,and thrombin time,prothrombin time and international standardized ratio were significantly lower than those in warfarin group(P<0.05).Before and after adjusting for confounders,there were no significant differences in the risk of new thrombosis,bleeding events and all-cause death between two groups(P>0.05).Multivariate Cox regression analysis showed that combined use of non steroidal antiinflammatory drug and low-dose rivaroxaban were risk factors for death in elderly patients with atrial fibrillation(P<0.05).Conclusion The efficacy and safety of rivaroxaban in elderly patients with atrial fibrillation are not inferior to warfarin.

关 键 词：利伐沙班 心房颤动 抗凝效果 安全性 

分 类 号：R973.2[医药卫生—药品]