低剂量利伐沙班应用于老年心房颤动合并急性冠脉综合征患者的有效性和安全性研究  

Study on the effectiveness and safety of low-dose rivaroxaban in elderly patients with atrial fibrillation and acute coronary syndrome

作　　者：文贤 曾显峰[2] 苏蕊雅[2] WEN Xian;ZENG Xianfeng;SU Ruiya(Coronary Heart Disease Care unit of the First Affiliated Hospital of Nanyang Medical College;Cardiovascular intensive care Unit of the First Affiliated Hospital of Nanyang Medical College,Nan Yang,473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院冠心病监护病房,河南南阳473000 [2]南阳医学高等专科学校第一附属医院心血管重症监护病房,河南南阳473000

出　　处：《航空航天医学杂志》2025年第3期262-264,共3页Journal of Aerospace medicine

摘　　要：目的对低剂量利伐沙班应用于老年心房颤动合并急性冠脉综合征患者的有效性和安全性进行研究。方法选取我院2021年06月-2023年06月期间收录的老年房颤(Atrial fibrillation,AF)合并急性冠脉综合征(Acute coronary syndrome,ACS)患者106例,采取利伐沙班药物抗凝治疗,根据给药剂量的不同分为高剂量组(n=48)和低剂量组(n=58),对比分析两组患者的治疗效果、治疗前后凝血功能指标情况、心肌生物标志物情况和治疗后的心血管不良事件(Major adverse cardiovascular events,MACE)发生情况。结果两组患者治疗后的PT、PTT、TT等凝血指标均有所升高,FIB有所下降,组内治疗前后对比差异具有统计学意义(P<0.05);且低剂量组治疗后各指标的变化程度比高剂量组更大,两组对比差异具有统计学意义(P<0.05)。两组患者治疗后的CK-MB、cTnI等心肌生物标志物均有所下降,组内治疗前后对比差异具有统计学意义(P<0.05);且低剂量组治疗后各指标的变化程度比高剂量组更大,两组对比差异具有统计学意义(P<0.05)。低剂量组治疗后出现脑栓塞1人,占比2.08%,MACE发生率2.08%,高剂量组治疗后出现脑卒中3人,占比5.17%,脑栓塞3人,占比5.17%,深静脉血栓2人,占比3.45%,MACE发生率13.79%,低剂量组的MACE发生率要低于高剂量组,两组对比差异具有统计学意义(P<0.05)。两组出血事件发生率比较差异无统计学意义(χ^(2)=1.216,P>0.05)。结论低剂量利伐沙班应用于老年AF合并ACS相比高剂量具备更高的有效性和安全性。Objective To study the efficacy and safety of low-dose rivaroxaban in elderly patients with atrial fibrillation and acute coronary syndrome.effectiveness and safety studies.Methods 106 elderly patients with atrial fibrillation(AF)combined with acute coronary syndrome(ACS)admitted to our hospital from June 2021 to June 2023 were selected and treated with rivaroxaban.Coagulation therapy was divided into high-dose group(n=48)and low-dose group(n=58)according to different dosages.Comparative analysis was made on the therapeutic effect,coagulation function indicators and myocardial biomarkers of the two groups of patients before and after treatment.and the occurrence of major adverse cardiovascular events(MACE)after treatment.Results After treatment,the PT,PTT,TT and other coagulation indicators of the two groups of patients increased,and the FIB decreased.The difference between the two groups before and after treatment was statistically significant(P&lt;0.05);and the low-dose group after treatment The degree of change in the index was greater than that in the high-dose group,and the difference between the two groups was statistically significant(P&lt;0.05).Myocardial biomarkers such as CK-MB and cTnI decreased in both groups after treatment,and the difference before and after treatment in the group was statistically significant(P&lt;0.05);and the low-dose group had a higher degree of change in each index after treatment.The dosage group was larger,and the difference between the two groups was statistically significant(P&lt;0.05).One person in the low-dose group developed cerebral embolism after treatment,accounting for 2.08%,and the incidence rate of MACE was 2.08%.In the high-dose group,3 people suffered from stroke,accounting for 5.17%,and 3 people had cerebral embolism,accounting for 5.17%.Deep vein There were 2 patients with thrombosis,accounting for 3.45%,and the incidence rate of MACE was 13.79%.The incidence rate of MACE in the low-dose group was lower than that in the high-dose group,and the difference betwee

关 键 词：老年房颤 急性冠脉综合征 利伐沙班 治疗效果 

分 类 号：R541.75[医药卫生—心血管疾病]