双联抗血小板抗凝治疗冠心病伴心房颤动

Dual antiplatelet anticoagulant therapy for coronary heart disease with atrial fibrillation

目的分析双联抗血小板治疗冠心病合并心房颤动患者的疗效,并对患者栓塞和出血的风险,以及对血管内皮功能的影响进行评价。方法选取我科107例冠心病合并心房颤动患者,随机分组。对照组53例给予华法林钠进行抗凝治疗,观察组54例给予硫酸氢氯吡格雷联合阿司匹林双联抗血小板治疗,对比两组患者栓塞及出血风险,不良事件发生率,血管内皮功能。结果干预后观察组HAS-BLED和CHADS2评分、主要终点事件、出血、血清ET-1水平、次要终点事件发生率均低于对照组,血清VECF水平、血清NO水平均高于对照组(p<0.05)。结论冠心病合并心房颤动患者在硫酸氢氯吡格雷与阿司匹林双联抗血小板治疗后有效改善血管内皮功能,可降低出血风险及血栓发生率,减少不良事件发生。

Objective To analyze the efficacy of dual antiplatelet therapy for patients with coronary heart disease complicated with atrial fibrillation,and to evaluate the risk of embolism and bleeding,as well as the effect on vascular endothelial function.Methods One hundred and seven patients with coronary heart disease complicated with atrial fibrillation were randomly divided into two groups.Fifty-three patients in the control group were given warfarin sodium for anticoagulant therapy,and 54 patients in the observation group were given clopidogrel hydrogen sulfate combined with aspirin for dual antiplatelet therapy.The risk of embolism and bleeding,incidence of adverse events and vascular endothelial function were compared between the two groups.Results After intervention,the observation group had lower HAS--BLED and CHADS2 scores,primary end point events,bleeding,serum ET-1 level and incidence of secondary end point events,and the serum VECF level and serum NO level were higher than those in the control group(p<0.05).Conclusions Clopidogrel bisulfate combined with aspirin can effectively improve vascular endothelial function,reduce the risk of bleeding and thrombosis,and reduce the incidence of adverse events in patients with coronary heart disease combined with atrial fibrillation.