口服抗凝剂和射频消融对心房颤动患者认知功能的影响

Effects of anticoagulation and radiofrequency ablation on cognitive function in patients with atrial fibrillation

目的探讨抗凝药物和射频消融对无卒中病史的非瓣膜性心房颤动患者认知功能的影响。方法收集2016年11月至2017年8月就诊于南昌大学第二附属医院的无卒中病史的非瓣膜性房颤患者115例,分为华法林组39例、达比加群组29例、射频消融组34例及对照组13例(未使用抗凝和射频消融治疗的患者)。于入组时和随访6个月后通过蒙特利尔认知评估量表(MoCA)进行认知功能评分,比较各组MoCA评分的结果。结果(1)各组患者入组时与随访6个月后MoCA评分比较差异无统计学意义(均P>0.05)。(2)随访前后MoCA总分差值比较四组间差异有统计学意义(均P<0.05)。结论抗凝治疗对无卒中的非瓣膜性房颤患者的认知功能损害具有保护作用。新型口服抗凝药、射频消融对无卒中的非瓣膜性房颤患者的认知功能损害具有保护作用,其作用与华法林相当。

Objective To investigate the effects of anticoagulants and radiofrequency ablation on cognitive function in patients with non-valvular atrial fibrillation without stroke history.Methods A total of 115 patients with non-valvular atrial fibrillation without stroke history were enrolled in the Second Affiliated Hospital of Nanchang University between November 2016 and August 2017.There were 39 patients in the warfarin group,29 in the Dabigatran group,34 in the radiofrequency ablation group,and 13 in the control group(patients without anticoagulant and radiofrequency ablation).Cognitive function was scored by Montreal Cognitive Assessment Scale(MoCA)at the inception of the study and at follow-up visit after 6 months,the MoCA scores were compared in each group.Results(1)There was no significant difference between the score of MoCA at the time of enrollment and 6 months after followup in each group(all P>0.05).(2)Difference of the MoCA total scores before and after follow-up between the four groups had statistical significance(all P<0.05).Conclusions Anticoagulant therapy has protective effect on cognitive impairment in patients with non-valvular atrial fibrillation without stroke.Novel oral anticoagulation and radiofrequency ablation has protective effect on cognitive impairment in patients with non-valvular atrial fibrillation without stroke,which is equivalent to warfarin.