利伐沙班与华法林对心房颤动伴左心房血栓形成患者的疗效观察

Efficacy of Rivaroxaban and Warfarin in Patients with Atrial Fibrillation and Left Atrial Thrombosis

目的探讨利伐沙班与华法林对心房颤动伴左心房血栓形成患者的疗效。方法选择2017年3月至2018年11月148例心房颤动伴左心房血栓形成患者,随机分为华法林组与利伐沙班组各74例。比较两组治疗后凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)、D-二聚体(D-D)、血清血管假血友病因子(vWF)、血栓调节蛋白(TM)以及血栓溶解和血栓栓塞事件、出血事件等。结果治疗后与华法林组比较,利伐沙班组PT、APTT、TT及D-D水平明显降低,Fbg明显升高,比较具有统计学意义(P<0.05)。与华法林组比较,研究组vWF水平明显降低,而TM水平明显升高,比较具有统计学意义(P<0.05)。利伐沙班组血栓溶解率为89.2%,血栓栓塞率为0.0%,华法林组血栓溶解率为70.3%,血栓栓塞率为4.1%,两组的血栓溶解率比较具有统计学意义(P<0.05),血栓栓塞发生率比较无统计学意义(P>0.05)。两组均无严重出血事件发生,比较无统计学意义(P>0.05)。结论利伐沙班对心房颤动伴左心房血栓形成患者的血栓溶解效果一定程度上优于华法林。

Objective To investigate the efficacy of rivaroxaban and warfarin in patients with atrial fibrillation associated with left atrial thrombosis.Methods 148 patients with atrial fi brillation accompanied by left atrial thrombosis from March 2017 to November 2018 were randomly divided into warfarin group and rivaroxaban group,each with 74 cases.After treatment,prothrombin time(PT),activated partial prothrombin time(APTT),thrombin time(TT),d-dimer(d-d),serum vascular pseudohemophilia factor(vWF),thromboregulatory protein(TM),thrombolytic and thromboembolic events and bleeding events were compared between the two groups.Results After treatment,compared with warfarin group,the levels of PT,APTT,TT and d-d in rivaroxaban group were signifi cantly reduced,and Fbg was signifi cantly increased,and the comparison were statistical signifi cance(P<0.05).Compared with the control group,vWF and TM levels in the study group were signifi cantly reduced,and the comparison were statistical signifi cance(P<0.05).Thrombolysis rate of the rivaroxaban group was 89.2%,thromboembolism rate was 0.0%,thromboembolism rate was 70.3%and thromboembolism rate was 4.1%in the warfarin group.The thromboolysis rate of the two groups were statistically signifi cant(P<0.05),while the thromboembolism rate were not statistically signifi cant(P>0.05).No serious bleeding events occurred in the two groups,and the comparison was not statistically signifi cant(P>0.05).Conclusion The effect of rivaroxaban on thrombolysis of atrial fi brillation patients with left atrial thrombosis was better than warfarin to some extent.