新型口服抗凝药联合阿司匹林治疗非瓣膜性房颤的临床分析

Clinical analysis of a new oral anticoagulant drug combined with Aspirin in the treatment of nonvalvular atrial fibrillation

目的探讨新型口服抗凝药(达比加群酯)联合阿司匹林治疗非瓣膜性房颤的的临床效果。方法选取我院2014年2月~2016年8月收治的150例非瓣膜性房颤患者作为研究对象,按照随机数字表法将其分为对照组、研究1组和研究2组,每组各50例。对照组患者给予华法林治疗,研究1组患者给予达比加群酯治疗,研究2组患者给予阿司匹林片联合达比加群酯治疗。比较三组患者治疗前后凝血指标变化情况以及脑出血、上消化道出血、短暂性脑缺血发作、肺栓塞、脑栓塞、死亡事件等的发生情况。结果治疗前,三组患者的各项凝血指标比较,差异无统计学意义(P>0.05)。治疗后,三组患者的各项凝血指标均显著高于治疗前,差异有统计学意义(P<0.05),三组患者的各项凝血指标比较,差异无统计学意义(P>0.05)。三组患者均未出现肺栓塞、死亡事件。研究1组、研究2组患者的短暂性脑缺血发作、脑栓塞、脑出血、上消化道出血事件发生率均低于对照组,差异有统计学意义(P<0.05)。研究1组患者的脑出血、上消化道出血事件发生率均低于研究2组,差异有统计学意义(P<0.05)。结论在非瓣膜性房颤患者治疗中,达比加群酯和阿司匹林片联合治疗相较于达比加群酯单独用药而言,疗效并无显著提高,反而增加出血风险。联合用药相较于华法林单独用药而言,可降低短暂性脑缺血发作、脑栓塞等事件发生率。

Objective To investigate the clinical effect of new oral anticoagulant （Dabigatran） combined with Aspirin in the treatment of nonvalvular atrial fibrillation.Methods One hundred and fifty cases of nonvalvular atrial fibrillation treated in our hospital from February 2014 to August 2016 were selected as the subjects.According to the random number table method,they were divided into control group,research group 1 and research group 2,50 cases in each group.The control group was treated with Warfarin,and the research group t was treated with Dabigatran,and the research group 2 was treated with Aspirin Tablets combined with Dabigatran.The changes of coagulation index and cerebral hemorrhage,upper gastrointestinal bleeding,transient ischemic attack,pulmonary embolism,cerebral embolism and death were compared in the three groups before and after treatment.Results Before treatment,there was no significant difference in coagulation index between the three groups （P〉0.05）.After treatment,the coagulation indexes in the three groups were significantly higher than those before treatment,and the differences were statistically significant （P〈0.05）,while there was no significant difference in coagulation index in the three groups after treament （P〉0.05）.No pulmonary embolism and death were found in all three groups.The incidence of transient ischemic attack,cerebral embolism,cerebral hemorrhage and upper gastrointestinal bleeding of research group 1 and research group 2 were both lower than those in the control group,and the differences were statistically significant （P〈0.05）.The incidence of hemorrhage and upper gastrointestinal bleeding of research group 1 were lower than those in the research group 2~nd the differences were statistically significant （P〈0.05）. Conclusion In the treatment of nonvalvular atrial fibrillation,Dabigatran combined with Aspirin Tablets has no signifi- cant improvement in efficacy compared with Dabigatran alone,but increases the risk of bleeding.Compared with warfarin alone,combination therapy can reduce the incidence of transient ischemic attack,cerebral embolism and other events.