低剂量利伐沙班对老年非瓣膜性房颤病人凝血功能的影响

Effect of low dose rivaroxaban on coagulation function in elderly patients with non valvular atrial fibrillation

目的探究低剂量利伐沙班对老年非瓣膜性房颤作用及对病人凝血酶原时间(PT)、凝血酶时间(TT)、血小板计数(PLT)水平影响。方法选取登封市中医院2020年1月-2021年5月期间86例老年非瓣膜性房颤患者为研究对象,以随机数字表法分为对照组、观察组,各43例,均接受利伐沙班治疗,其中对照组应用国际推荐剂量15 mg治疗,观察组应用低剂量(10 mg)治疗,两组均持续治疗3个月,比较两组治疗有效率、治疗前后凝血指标[PT、TT、PLT、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)]水平及血栓栓塞发生率、出血发生率。结果观察组治疗有效率为90.70%,与对照组95.35%相近(P>0.05);治疗后观察组PT、TT、APTT水平较对照组低(P<0.05);观察组血栓栓塞发生率为4.65%,与对照组2.33%相近(P>0.05);观察组出血事件发生率为2.33%,较对照组16.28%低(P<0.05)。结论在对老年非瓣膜性房颤患者抗凝治疗中,应用常规剂量及低剂量利伐沙班治疗效果相近,但可显著降低出血事件发生率。

Objective To investigate the effect of low-dose rivaroxaban on elderly patients who underwent non valvular atrial fibrillation and its effect on prothrombin time(PT),thrombin time(TT)and platelet count(PLT).Methods 86 elderly patients with non valvular atrial fibrillation were selected as the study subjects from January 2020 to May 2021 at the Dengfeng Traditional Chinese Medicine Hospital.They were randomly divided into control group and observation group,with 43 cases in each group.Each group were treated with rivaroxaban.Amongwhichthe control group was treated with the international recommended dose of 15mg,and the observation group was treated with low dose(10mg).Both groups were treated for 3 months.The treatment efficiency,the levels of coagulation indexes[PT,TT,PLT,fibrinogen(FIB),activated partial thromboplastin time(APTT)]and the incidence of thromboembolism and bleeding before and after treatmentof the two groupswerecompared.Results The effective rate of treatmentinthe observation group was 90.70%,which was close to 95.35%of the control group(P>0.05).After treatment,the levels of PT,TT and APTT in the observation group were lower than those in the control group(P<0.05).The incidence of thromboembolism in the observation group was 4.65%,which was close to 2.33%in the control group(P>0.05),and the incidence of bleeding events in the observation group was 2.33%,which was lower than 16.28%in the control group(P<0.05).Conclusion In the anticoagulant treatment of elderly patients with non valvular atrial fibrillation,the effect of routine dose and low-dose rivaroxaban is similar,but it can significantly reduce the incidence of bleeding events.