达比加群酯在冠心病心房颤动射频导管消融术后抗凝治疗中的应用效果观察

Application effect of dabigatran etexilate in anticoagulant therapy after radiofrequency catheter ablation in coronary heart disease and atrial fibrillation

目的 探究冠心病心房颤动射频导管消融术后抗凝治疗中应用达比加群酯的效果。方法 56例应用射频导管消融术治疗的冠心病心房颤动患者,采用随机数字表法分为对照组和研究组,每组28例。对照组患者采用华法林治疗,研究组患者采用达比加群酯治疗。比较两组患者凝血功能指标[凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB)、血酶时间(TT)]、出血发生情况、不良反应发生情况。结果 治疗前,两组患者PT、APTT、TT、FIB水平比较差异无统计学意义(P>0.05);治疗后,两组患者PT、APTT、TT水平均高于治疗前, FIB水平低于治疗前,差异具有统计学意义(P<0.05);两组治疗后PT、APTT、TT、FIB水平比较,差异均无统计学意义(P>0.05)。研究组出血发生率为3.57%,低于对照组的21.43%,差异具有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(χ^(2)=0.220, P=0.639>0.05)。结论 射频导管消融术治疗冠心病心房颤动患者,应用达比加群酯进行术后抗凝治疗,效果确切,可推广应用。

Objective To investigate the effect of dabigatran etexilate in anticoagulant therapy after radiofrequency catheter ablation in atrial fibrillation and coronary heart disease.Methods A total of 56 patients with coronary heart disease and atrial fibrillation undergoing radiofrequency catheter ablation were divided into the control group and the research group by a random numerical table,with 28 cases in each group.Patients in the control group were treated with warfarin,and patients in the research group were treated with dabigatran etexilate.Both groups were compared in terms of coagulation function indexes[prothrombin time(PT),activated partial prothrombin time(APTT),fibrinogen(FIB),thrombin time(TT)],bleeding rate,and occurrence of adverse reactions.Results Before treatment,there was no statistically significant difference in PT,APTT,TT,and FIB between the two groups(P>0.05).After treatment,PT,APTT and TT of the two groups were higher than those of this group before treatment,and FIB was lower than that of this group before treatment.All the differences were statistically significant(P<0.05).After treatment,the differences in PT,APTT and TT between the two groups were not statistically significant(P>0.05).The bleeding rate in the research group was 3.57%,which was lower than 21.43%in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.220,P=0.639>0.05).Conclusion Dabigatran etexilate has definite effect on patients with coronary heart disease and atrial fibrillation undergoing radiofrequency catheter ablation,and can be promoted and applied.