非瓣膜性房颤抗凝治疗中达比加群酯的运用

Application of dabigatran etexilate in anticoagulation treatment of nonvalvular atrial fibrillation

目的探究在非瓣膜性心房颤动(房颤)的抗凝治疗中达比加群酯的临床应用效果。方法 120例非瓣膜性房颤的患者作为研究对象,结合患者接受诊治的先后顺序分为对照组和观察组,每组60例。对照组患者应用华法林治疗,观察组患者则应用达比加群酯进行治疗,对比两组患者的临床治疗效果以及药物应用的安全性。结果治疗前,对照组国际标准化比值(INR)为(1.04±0.30)、活化部分凝血活酶时间(APTT)为(40.90±2.70)s,观察组INR为(1.03±0.10)、APTT为(40.60±2.00)s;治疗后,对照组INR为(2.26±0.60)、APTT为(43.80±3.10)s,观察组INR为(2.61±0.90)、APTT为(47.90±2.90)s;两组患者治疗后抗凝指标均有效改善,同时观察组患者的改善情况优于对照组,差异具有统计学意义(P<0.05)。观察组患者在治疗过程中动脉血管栓塞事件、出血事件发生率明显低于对照组(P<0.05),两组患者的不良反应发生率比较差异无统计学意义(P>0.05)。结论在非瓣膜性房颤抗凝治疗过程中应用达比加群酯能够有效改善患者的临床治疗效果,同时无附加的不良反应出现,值得在心内科治疗中推广应用。

Objective To investigate clinical application effect by dabigatran etexilate in anticoagulation treatment of nonvalvular atrial fibrillation. Methods A total of 120 patients with nonvalvular atrial fibrillation as study subjects were divided by admission order into control group and observation group, with 60 cases in each group. The control group received warfarin for treatment, and the observation group received dabigatran etexilate for treatment. Comparison was made on clinical curative effect and drug use safety between the two groups. Results Before treatment, the control group had international normalized ratio （INR） as （1.04 ± 0.30） and activated partial thromboplastin time （APTT） as （40.90 ± 2.70） s, and the observation group had INR as （1.03 ± 0.10） and APTT as （40.60±2.00） s. After treatment, the control group had INR as （2.26 ±0.60） and APTT as （43.80 ± 3.10） s, and the observation group had INR as （2.61 ± 0.90） and APTT as （47.90 ± 2.90） s. Both groups had effective improvements in antieoagulation indexes after treatment, and the observation group had better improvements than the control group. Their difference had statistical significance （P〈0.05）. The observation group had obviously lower incidences of arterial embolism events and hemorrhage than the control group （P〈0.05）. There was no statistically significant difference of incidence of adverse reactions between the two groups （P〉0.05）. Conclusion Implement of dabigatran etexilate in anticoagulation treatment of nonvalvular atrial fibrillation can effectively improve clinical curative effect, along with no additional adverse reactions. This method is worth promoting and applying in department of cardiology.