非瓣膜性房颤合并2型糖尿病患者使用达比加群酯抗凝治疗的临床效果  

Clinical Efficacy of Anticoagulant Treatment with Dabigatranate in Patients with Non-valvular Atrial Fibrillation Complicated with Type 2 Diabetes Mellitus

作　　者：赵亚男 倪铭 黄佳佳 孙文娜 李君霞[1] ZHAO Yanan;NI Ming;HUANG Jiajia;SUN Wenna;LI Junxia(Department of Pharmacy,Henan Province Chest Hospital,Zhengzhou 450003,China;Department of Pharmacy,Fuwai Central China Cardiovascular Hospital,Zhengzhou 451450,China;Department of Pharmacy,Xiangcheng First People’s Hospital,Zhoukou 466200,China)

机构地区：[1]河南省胸科医院药学部,河南郑州450003 [2]阜外华中心血管病医院药学部,河南郑州451450 [3]项城市第一人民医院药剂科,河南周口466200

出　　处：《河南医学研究》2025年第6期1075-1079,共5页Henan Medical Research

基　　金：河南省科技攻关项目(232102310248);河南省医学科技攻关计划联合共建项目(LHGJ20230111)。

摘　　要：目的探讨达比加群酯在非瓣膜性心房颤动(NVAF)合并2型糖尿病(T2DM)患者中抗凝治疗的有效性及安全性。方法本研究纳入2022年3月至2024年3月河南省胸科医院心血管病区收治的243例NVAF合并T2DM患者,随机分为两组。观察组(119例)接受达比加群酯抗凝治疗,对照组(124例)接受华法林抗凝治疗,所有患者均完成了至少6个月的抗凝治疗。观察并记录两组患者治疗前、治疗3个月后、治疗6个月后的各项血生化指标和治疗期间发生的血栓栓塞或出血事件,以及其他不良反应。结果观察组血栓栓塞事件及缺血性脑卒中的发生率为7.5%,对照组发生率为10.48%,两组差异无统计学意义(P>0.05)。观察组的总出血事件和一般出血事件发生率低于对照组,差异有统计学意义(P<0.05)。观察组和对照组的患者在治疗3个月和6个月后的血清肌酐、天门冬氨酸转氨酶、丙氨酸转氨酶、总胆红素及总胆固醇水平与治疗前相比,差异无统计学意义(P>0.05);治疗6个月后,两组生化指标中的糖化血红蛋白和空腹血糖水平,与治疗前比较,差异有统计学意义(P<0.05)。在不良反应的比较中,对照组发生的药物不良反应共计37例,观察组共计14例,差异有统计学意义(P<0.05)。结论在NVAF合并T2DM患者中,达比加群酯与华法林在临床疗效上表现相当,但达比加群酯在降低出血事件和减少不良反应方面更具优势,为此类患者提供了一种更安全的抗凝治疗选择。Objective To investigate the efficacy and safety of dabigatron in the anticoagulant treatment of patients with non-valvular atrial fibrillation(NVAF)combined with type 2 diabetes mellitus(T2DM).Methods A total of 243 patients with NVAF combined with T2DM admitted to the Cardiovascular Ward of Henan Chest Hospital from March 2022 to March 2024 were randomly divided into two groups.The observation group(119 cases)received anticoagulant therapy with dabigatran,and the control group(124 cases)received anticoagulant therapy with warfarin.All patients had completed anticoagulant therapy for at least 6 months.Blood biochemical indexes,thromboembolism or bleeding events and other adverse reactions occurred during treatment were observed and recorded before,after 3 months and after 6 months of treatment in the two groups.Results The incidence of thromboembolic events and ischemic stroke was 7.5%in the observation group and 10.48% in the control group,with no statistical significance between the two groups(P>0.05).The incidence of total and general bleeding events in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in serum creatinine,aspartate aminotransferase,alanine aminotransferase,total bilirubin and total cholesterol levels between observation group and control group after 3 months and 6 months of treatment compared with before treatment(P>0.05).After 6 months of treatment,the levels of HBA1c and fasting blood glucose in the two groups were significantly different from those before treatment(P<0.05).In the comparison of adverse reactions,37 cases of adverse drug reactions occurred in the control group and 14 cases in the observation group,the difference was statistically significant(P<0.05).Conclusion In patients with NVAF combined with T2DM,dabigatran has the same clinical efficacy as warfarin,but it has more advantages in reducing bleeding events and adverse reactions,providing a safer anticoagulant treatment

关 键 词：非瓣膜性心房颤动 2型糖尿病 达比加群酯 华法林 血栓栓塞 出血 

分 类 号：R972[医药卫生—药品]