达比加群酯与利伐沙班在非瓣膜性AF患者抗凝治疗中的临床效果比较

Clinical effects of dabigatran etexilate and rivaroxaban in anticoagulation in patients with non-valvular atrial fibrillation

目的分析比较不同抗凝药物用于非瓣膜性心房颤动(atrial fibrillation,AF)临床治疗的效果以及安全性。方法选择2018年4月~2021年4月接受抗凝治疗的136例非瓣膜性AF患者为研究对象。其中,76例作为L组应用利伐沙班抗凝治疗,另60例作为D组应用达比加群酯治疗。对三个月后两组患者的凝血、血常规指标改善、出血及不良事件情况进行观察并分析比较。结果用药三个月后两组的血小板与用药前相比提升显著(P<0.05);用药后L组的红细胞以及凝血酶原时间明显高于用药前(P<0.05);用药后组间比较,L组与D组各指标检测情况无明显差异。L组用药期间出血总发生率34.21%,明显高于D组率11.67%(P<0.01);L组不良事件总发生率22.37%,与D组21.67%比较无统计差异。结论利伐沙班与达比加群酯两种抗凝药物对非瓣膜性AF的疗效理想,但达比加群酯的安全系数更高。

AIM To analyze and compare the clinical effects and safety of different anticoagulant drugs in the clinical treatment of non-valvular atrial fibrillation(NAVF).METHODS A total of 136 NVAF patients who received anticoagulant therapy from April 2018 to April 2021 were selected.Among them,76 patients were treated with rivaroxaban anticoagulant therapy in group L and 60 patients were treated with dabigatran etexilate in group D.Coagulation,improvement of blood routine indexes,bleeding and adverse events were analyzed and compared between the two groups after three months of medication.RESULTS Three months after the treatment,the platelets of the two groups increased significantly compared with those before the treatment(P<0.05).The red blood cell and prothrombin time in L group after treatment was significantly higher than those of that before treatment(P<0.05).After the medication,there was no significant difference between group L and group D.The total incidence of bleeding during medication in group L was 34.21%,which was significantly higher than that of the rate of 11.67%in group D(P<0.01).The total incidence of adverse events in group L was 22.37%compared with 21.67%in group D,and there was no statistical difference in both of those.CONCLUSION Both rivaroxaban and dabigatran etexilate achieve ideal clinical efficacy in patients with NVAF,but the lsafety factor of dabigatran etexilate is higher.