达比加群酯治疗老年非瓣膜性心房颤动患者血栓栓塞的效果观察

Effect of dabigatran etexilate on thromboembolism in elderly patients with non-valvular atrial fibrillation

目的探讨达比加群酯治疗老年非瓣膜性心房颤动血栓栓塞的效果,为临床治疗提供参考。方法选取北京民航总医院2018年7月—2019年4月收治的102例老年非瓣膜性心房颤动患者,随机分为观察组和对照组,各51例。对照组给予法华林治疗,观察组给予达比加群酯治疗。检测并比较两组凝血酶原时间(PT)、凝血活酶时间(APTT)、国际标化比值(INR)、凝血酶时间(TT)、D-二聚体、血浆纤维蛋白原(FIB);观察并比较两组栓塞事件、出血事件和不良反应发生情况。结果治疗前,两组PT、APTT、INR、TT、D-二聚体和FIB水平比较,差异无统计学意义(P>0.05);治疗后,两组PT、APTT、INR、TT和FIB水平均高于本组治疗前,D-二聚体水平低于本组治疗前,且两组比较,差异有统计学意义(P<0.05)。观察组栓塞事件发生率为5.88%、出血事件发生率为9.80%,均低于对照组的11.76%和35.29%,差异均有统计学意义(χ2=1.097、9.487,P<0.05)。观察组不良反应总发生率为31.37%,与对照组的29.41%比较,差异无统计学意义(P>0.05)。结论达比加群酯可有效减少老年非瓣膜性心房颤动患者栓塞事件和出血事件的发生。

Objective To investigate the effect of dabigatran etexilate on thromboembolism in elderly patients with non-valvular atrial fibrillation.Methods A total of 102 elderly patients with non-valvular atrial fibrillation who were treated in Beijing Civil Aviation General Hospital from July 2018 to April 2019 were randomly divided into observation group and control group,with 51 cases each.The control group was treated with valaclin and the observation group was given dabigatran etexilate.Prothrombin time(PT),thromboplastin time(APTT),international standardization ratio(INR),thrombin time(TT),D-dimer,plasma fibrinogen(FIB)in the two groups were measured and compared.Embolism events,bleeding events and adverse reactions were observed and compared.Results Before treatment,there was no significant difference in the levels of PT,APTT,INR,TT,D-dimer and FIB between the two groups(P>0.05).After treatment,the PT,APTT,INR and TT levels were increased in two groups,D-dimer level was decreased in two group,and there were significant differences between the two groups.(P<0.05).The incidence of embolic events and the incidence of bleeding events in the observation group were lower than those in the control group(5.88%vs.11.76%,9.80%vs.35.29%),the differences were statistically significant(χ2=1.097,9.487,P<0.05).There was no significant difference in total incidence of adverse reactions between the observation group and the control group(31.37%vs.29.41%,P>0.05).Conclusion Dabigatran etexilate is effective in the treatment of thromboembolism in elderly patients with non-valvular atrial fibrillation.