利伐沙班和氯吡格雷双联抗栓对急性冠脉综合征合并房颤患者经皮冠状动脉介入术后的影响  

The Effect of Dual Antithrombotic Therapy with Rivaroxaban and Clopidogrel after Percutaneous Coronary Intervention Patients Acute Coroary Syndroe Complicated with Atrial Fibrillation

作　　者：杜海歌 DU Haige(Department of Cardiology,Xinyi People's Hospital,Xinyi,Jiangsu,221400,China)

机构地区：[1]新沂市人民医院心内科,江苏新沂221400

出　　处：《中外医疗》2025年第7期43-47,共5页China & Foreign Medical Treatment

摘　　要：目的分析利伐沙班和氯吡格雷对急性冠脉综合征合并房颤患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后影响。方法方便选取2022年3月—2023年10月新沂市人民医院收治的138例急性冠脉综合征合并房颤患者为研究对象,按照不同治疗方法分为两组,各69例,两组患者均行PCI术,对照组采用阿司匹林+氢氯吡格雷+华法林治疗,研究组采用利伐沙班+氯吡格雷双联抗栓治疗。对比两组凝血功能[纤维蛋白原(fibriogen,FIB)、凝血酶时间(throbin time,TT)、凝血酶原时间(prothombin time,PT)、活化部分凝血酶时间(activated parial thromboplastin time,APTT)、D-二聚体(D-dmer,D-D)]、炎症指标、并发症发生率、心功能。结果治疗后,研究组FIB水平为(2.37±0.18)g/L,TT为(17.57±0.38)s,PT为(15.63±0.56)s,APTT为(39.47±2.23)s,D-D水平为(0.57±0.09)mg/L,优于对照组的(3.69±0.78)g/L、(15.91±0.96)s、(13.39±0.67)s、(36.83±2.72)s和(0.83±0.12)mg/L,差异均有统计学意义(t=13.697,13.355,21.308,6.235,14.398;P均<0.05);治疗后,研究组炎症指标水平低于对照组,差异有统计学意义(P<0.05);研究组并发症总发生率低于对照组,差异有统计学意义(P<0.05);研究组的心功能指标优于对照组,差异有统计学意义(P<0.05)。结论利伐沙班和氯吡格雷双联抗栓治疗急性冠脉综合征合并房颤PCI术后患者,能够改善患者凝血功能,降低炎症指标,提升心功能。Objective To analyze the effects of rivaroxaban and clopidogrel on patients with acute coronary syndrome and atrial fibrillation after percutaneous coronary intervention(PCI).Methods From March 2022 to October 2023,138 patients with acute coronary syndrome complicated with atrial fibrillation in Xinyi People's Hospital were conveniently selected as the research objects.According to different treatment methods,they were divided into two groups,69 cases in each group.Both groups of patients underwent PCI.The control group was treated with aspirin+clopidogrel+warfarin,and the study group was treated with rivaroxaban+clopidogrel dual antithrombotic therapy.The coagulation function[fibrinogen(FIB),thrombin time(TT),prothombin time(PT),activated partial thromboplastin time(APTT),D-dimer(D-D)],inflammatory indicators,the incidence of complications and cardiac function were compared between the two groups.Results After the treatment,the FIB level in the study group was(2.37±0.18)g/L,the TT was(17.57±0.38)s,the PT was(15.63±0.56)s,the APTT was(39.47±2.23)s,the D-D level is(0.57±0.09)mg/L,better than(3.69±0.78)g/L,(15.91±0.96)s,(13.39±0.67)s,(36.83±2.72)s,(0.83±0.12)mg/L in the control group,the differences were statistically significant(t=13.697,13.355,21.308,6.235,3.956;all P<0.05).After treatment,the levels of inflammatory index in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).The total incidence of complication in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).The cardiac function index of the study group was better than that of the control group,and the difference was statistically significant(P<0.05).Conclusion The combination of rivaroxaban and clopidogrel in patients with acute coronary syndrome and atrial fibrillation after PCI can improve coagulation function,reduce inflammation index and improve cardiac function.

关 键 词：利伐沙班 氯吡格雷 急性冠脉综合征 凝血功能 炎症指标 不良反应 

分 类 号：R541.4[医药卫生—心血管疾病]