达比加群酯对房颤伴心力衰竭患者的临床疗效

Therapeutic effect of dabigatran etexilate on patients with atrial fibrillation complicated heart failure

目的:探讨达比加群酯对房颤伴心力衰竭患者的抗凝疗效。方法:120例房颤伴心力衰竭患者被随机均分为华法林组和达比加群酯组,两组均在常规治疗的基础上接受对应药物治疗,疗程3个月。观察比较两组治疗前后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fg)、血浆凝血酶原时间国际标准化比较(INR),不良反应以及随访1年时的出血/血栓并发症发生率。结果:与治疗前比较,治疗后两组PT、APTT、TT、Fg水平和INR均显著升高,P<0.05或<0.01;与华法林组比较,达比加群酯组治疗后PT[(31.8±4.0)s比(35.2±3.2)s]、APTT[(41.7±4.2)s比(43.4±4.6)s]和INR[(2.3±0.3)比(2.7±0.5)]升高更显著,P<0.05或<0.01;达比加群酯组不良反应总发生率(25.00%比8.33%)以及随访1年内的出血/血栓并发症总发生率(35.00%比15.00%)均显著降低,P均<0.05。结论:达比加群酯能显著改善房颤伴心力衰竭患者的凝血功能,且用药安全性好,值得推广。

Objective:To explore anticoagulant therapeutic effect of dabigatran etexilate on patients with atrial fibrillation(AF)complicated heart failure(HF).Methods:A total of 120 AF+HF patients were randomly and equally divided into warfarin group and dabigatran etexilate group,both groups received corresponding medication based on routine treatment for three months.Prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(Fg),international normalized ratio(INR)before and after treatment,incidence rates of adverse reactions and hemorrhage/thrombotic complications during one-year follow-up were observed and compared between two groups.Results:Compared with before treatment,there were significant rise in PT,APTT,TT,Fg level and INR in two groups after treatment,P<0.05 or<0.01;compared with warfarin group after treatment,there were significant rise in PT[(31.8±4.0)s vs.(35.2±3.2)s],APTT[(41.7±4.2)s vs.(43.4±4.6)s]and INR[(2.3±0.3)vs.(2.7±0.5)]in dabigatran etexilate group,P<0.05 or<0.01.Total incidence rates of adverse reactions(8.33%vs.25.00%)and hemorrhage/thrombotic complications within one-year follow-up(15.00%vs.35.00%)in dabigatran etexilate group were significantly lower than those of warfarin group,P<0.05 both.Conclusion:Dabigatran etexilate can significantly improve coagulation function with good safety in AF+HF patients,which is worth extending.