低剂量利伐沙班用于非瓣膜性房颤患者导管射频消融术后抗凝治疗的效果及安全性  

Efficacy and safety of low-dose rivaroxaban for anticoagulant therapy after radiofrequency catheter ablation in patients with nonvalvular atrial fibrillation

作　　者：黄敏 甘萍 邓青 蒋国君 蒋文艳 覃清华 邓丽琳 王新云 夏中华 HUANG Min;GAN Ping;DENG Qing;JIANG Guojun;JIANG Wenyan;QIN Qinghua;DENG Lilin;WANG Xinyun;XIA Zhonghua(Department of Cardiovascular Medicine,the Second Affiliated Hospital of Guilin Medical University,Guangxi Zhuang Autonomous Region,Guilin 541199,China;不详)

机构地区：[1]桂林医学院第二附属医院心血管内科,广西壮族自治区桂林市541199 [2]桂林医学院第二附属医院药学部,广西壮族自治区桂林市541199

出　　处：《临床合理用药》2025年第11期16-19,23,共5页Chinese Journal of Clinical Rational Drug Use

基　　金：2022年广西自然科学基金(2022JJA140012)。

摘　　要：目的观察低剂量利伐沙班用于非瓣膜性房颤患者导管射频消融术后抗凝治疗的效果及安全性。方法回顾性收集2022年7月—2023年12月在桂林医学院第二附属医院行导管射频消融术治疗的非瓣膜性房颤患者203例,根据患者抗凝治疗方案分为低剂量利伐沙班组51例、标准剂量利伐沙班组105例、华法林组47例,比较3组术后3个月疗效及安全性。结果3组患者未出现缺血性脑卒中事件、其他全身性栓塞事件、全因死亡事件;3组房颤、房扑发生率比较差异无统计学意义(P>0.05)。术后3个月,低剂量利伐沙班组左房内径(LA)小于术前及同期华法林组,标准剂量利伐沙班组LA小于术前,射血分数(EF)高于术前(P<0.05);低剂量利伐沙班组与标准剂量利伐沙班组术后3个月LA、EF比较,以及华法林组术前、术后3个月LA、EF比较差异均无统计学意义(P>0.05)。3组患者均未出现大出血事件,小出血19例,非出血性不良反应事件13例。低剂量利伐沙班组、标准剂量利伐沙班组小出血事件发生率低于华法林组(P<0.01);低剂量利伐沙班组、标准剂量利伐沙班组小出血发生率及3组腹胀、头晕、乏力发生率比较差异均无统计学意义(P>0.05)。结论低剂量利伐沙班用于非瓣膜性心房颤动患者导管射频消融术后抗凝治疗效果明确,其安全性与标准剂量利伐沙班相似,且均高于华法林。Objective To observe the efficacy and safety of low-dose rivaroxaban for anticoagulant therapy after radiofrequency catheter ablation in patients with nonvalvular atrial fibrillation.Methods A total of 203 patients with nonvalvular atrial fibrillation who underwent radiofrequency catheter ablation in the Second Affiliated Hospital of Guilin Medical University from July 2022 to December 2023 were retrospectively collected.According to the anticoagulant treatment regimen,they were divided into low-dose rivaroxaban group(51 cases),standard-dose rivaroxaban group(105 cases)and warfarin group(47 cases).The efficacy and safety of the three groups were compared 3 months after surgery.Results No ischemic stroke,other systemic embolism or all-cause death occurred in three groups.There was no significant difference in the incidence of atrial fibrillation and atrial flutter among both groups(P>0.05).At 3 months after surgery,LA in low-dose rivaroxaban group was lower than before surgery and warfarin group,LA in standard-dose rivaroxaban group was lower than before surgery,EF was higher than before surgery(P<0.05).There was no significant difference in LA and EF 3 months after surgery between low-dose rivaroxaban group and standard-dose rivaroxaban group,and there was no significant difference in LA and EF before and 3 months after operation between warfarin group(P>0.05).There were no major bleeding events in both groups,a total of 19 small bleeding events,13 non-hemorrhagic adverse events.The incidence of small bleeding events in low-dose rivaroxaban group and standard-dose rivaroxaban group was lower than that in warfarin group(P<0.01).There was no significant difference in the incidence of small bleeding between the low-dose rivaroxaban group and the standard-dose rivaroxaban group,and the incidence of abdominal distension,dizziness and fatigue among the three groups(P>0.05).Conclusion The efficacy of low-dose rivaroxaban in anticoagulant therapy after radiofrequency catheter ablation in patients with nonvalvular atrial

关 键 词：非瓣膜性房颤 导管射频消融术 利伐沙班 低剂量 华法林 真实世界研究 

分 类 号：R54[医药卫生—心血管疾病]