高龄非瓣膜性心房颤动患者的抗凝治疗探讨

Exploration on anticoagulant therapy in elderly patients with non-valvular atrial fibrillation

目的探讨高龄老年非瓣膜性房颤患者的抗凝治疗疗效。方法选择在本院接受治疗的60例老年非瓣膜性房颤患者为研究对象,均给予华法林及利伐沙班抗凝治疗,将其分为老年组[n=32,年龄(73.22±5.75)岁]和高龄组[n=28,年龄(85.86±3.31)岁]。比较2组抗凝治疗后脑血管意外事件、外周血管栓塞、消化不良及皮肤黏膜出血等不良事件的发生率。结果高龄组脑血管意外事件发生率为10.71%,高于老年组的6.25%,但差异无统计学意义(P>0.05);高龄组使用华法林抗凝治疗的患者中出现3例脑出血,使用利伐沙班的患者中未出现脑出血,差异有统计学意义(P<0.05);2组外周血管栓塞事件发生率比较,差异无统计学意义(P>0.05);高龄组不良反应事件发生率为21.43%,低于老年组的21.88%,但差异无统计学意义(P>0.05)。结论高龄老年房颤患者应用利伐沙班治疗,脑血管意外发生率降低,且安全性较高。

Objective To investigate the effect of anticoagulant therapy in elderly patients with non-valvular atrial fibrillation.Methods A total of 60 non-valvular atrial fibrillation patients treated with warfarin and rivaroxaban were selected,and were divided into elderly group[n=32,with an average age of(73.22±5.75)years]and senile group[n=28,with an average age of(85.86±3.31)years].The incidence of cerebrovascular accident events,peripheral vascular thromboembolism,indigestion,skin mucosal bleeding of the two groups were compared.Results The incidence of cerebrovascular accident events in the senile group was significantly higher than that in the elderly group(10.71%vs.6.25%,P>0.05).There were 3 patients with cerebral hemorrhage treated by warfarin and no cerebral hemorrhage was found in patients treated by rivaroxaban,a significant difference was found(P<0.05).The incidence of peripheral vascular thromboembolism events in two groups showed no significant difference(P>0.05).The incidence of adverse events in the senile group was lower than that in the elderly group,but showed no significant difference in(21.43%vs.21.88%,P>0.05).Conclusion The elderly patients with atrial fibrillation treated by rivaroxaban have lower incidence of cerebrovascular accident events and it is safer.