达比加群酯与华法林对扩张型心肌病患者的抗凝疗效比较

Comparison of Anticoagulant Treatment Effect Between Dabigatran Etexilate and Warfarin in Patients with Dilated Cardiomyopathy

目的比较达比加群酯与华法林对窦性心律左心功能不全扩张型心肌病患者抗凝治疗的有效性及安全性。方法将符合入组标准的扩张型心肌病患者127例分为3组:对照组(42例,安慰药,po)、达比加群酯组(45例,150mg,bid,po)及华法林组(40例,2.5 mg·d^(-1),po),规律门诊随访21个月。结果对照组、达比加群酯组和华法林组血栓栓塞事件发生率分别为21.4%,0.0%,5.4%(P<0.01);出血事件发生率分别为2.3%,2.9%,18.9%(P<0.01)。达比加群酯组血栓栓塞事件发生率与华法林组差异无统计学意义(P>0.05),总出血事件发生率低于华法林组(P<0.05)。结论抗凝治疗可有效降低窦性心律左心功能不全扩张型心肌病患者血栓栓塞事件发生率,且达比加群酯的不良反应事件发生率低于华法林。

Objective To compare the effectiveness and safety of the anticoagulant therapy between dabigatran etexilate and warfarin for patients with sinus arrhythmia in dilated cardiomyopathy Methods Total 127 patients with dilated cardiomyopathy who met the criteria of this research were divided into three groups,including the control group(42 patients,placebo,po),dabigatran etexilate group(45 patients,150 mg,bid,po)and warfarin group(40 patients,2.5 mg·d-1,po).Regular clinical follow-up lasted for 21 months.Results The incidence of thromboembolic events in the control group,dabigatran etexilate group and the warfarin group was 21.4%,0.0%,5.4%(P<0.01),and the incidence of bleeding events was 2.3%,2.9%and 18.9%(P<0.01).There was no statistical difference of the incidence of thromboembolism between dabigatran etexilate group and warfarin group(P>0.05),and the incidence of total bleeding in dabigatran etexilate group was lower than that in warfarin group(P<0.05)Conclusion Anticoagulant therapy can effectively reduce the incidence of thromboembolic patients suffering from dilated cardiomyopathy with sinus rhythm and left ventricular dysfunction.Furthermore,as to the incidence rate of adverse events,dabigatran etexilate is lower than warfarin.