高风险冠心病合并房颤抗凝与双联抗栓治疗的临床比较

Clinical Comparison of Anticoagulation and Double Antithrombotic in the Treatment of High Risk Coronary Heart Disease with Atrial Fibrillation

目的:对比高风险冠心病合并房颤患者行抗凝与双联抗栓治疗的临床效果。方法:选取某院收治的138例高风险冠心病合并房颤患者进行研究,将患者随机分为两组。对照组69例采用双联抗栓治疗,观察组69例采用抗凝治疗,对比两组患者临床疗效。结果:治疗后随访3年,相对于对照组,观察组患者质子泵抑制剂使用率、主要终点事件发生率均明显降低(P<0.05);但组间在出血事件、次要终点事件发生率方面比较则均无较大差异(P>0.05);观察组患者栓塞风险评分(CHADS2)与对照组比较无较大差异(P>0.05),但观察组患者高于对照组(P<0.05)。结论:对高风险冠心病合并房颤患者行抗凝治疗效果显著,有利于降低栓塞风险,但治疗期间需做好对出血风险的控制。

Objective: To compare the clinical effects of anticoagulation and double antithrombotic therapy in the treatment of high risk coronary heart disease complicated with atrial fibrillation. Methods: 138 cases of high risk coronary heart disease patients with atrial fibrillation were selected and randomly divided into control group (double antithrombotic therapy) and observation group (anticoagulation treatment),with 69 cases in each group. The clinical efficacy of the two groups was compared. Results: After 3 years of follow-up, compared with the control group, the use of proton pump inhibitors and the incidence of major end-point events were significantly decreased in the observation group ( P < 0.05). However, there was no significant difference between groups in the incidence of bleeding events and secondary endpoint events ( P >0.05). There was no significant difference in embolism risk score (CHADS2) between the observation group and the control group ( P >0.05), but the patients in the observation group were higher than those in the control group ( P < 0.05). Conclusion: Anticoagulation therapy is effective in patients with high risk coronary heart disease complicated with atrial fibrillation, which is beneficial to reduce the risk of embolism, but it is necessary to control the risk of bleeding during the treatment.