阿司匹林与利伐沙班治疗非瓣膜性房颤合并轻度认知功能障碍患者的效果对比

Comparison of Effects of Aspirin and Rivaroxaban on Patients with Non-valvular Atrial Fibrillation Complicated with Mild Cognitive Impairment

目的:对比阿司匹林与利伐沙班治疗非瓣膜性房颤(NVAF)合并轻度认知功能障碍(MCI)患者的效果。方法:选取2020年4月-2022年1月南华大学衡阳医学院附属第一医院心内科收治的86例NVAF合并MCI患者为研究对象,根据随机数字表法将其分为阿司匹林组和利伐沙班组,各43例。两组均给予缓解症状、保护心功能等常规治疗3个月,阿司匹林组在常规治疗基础上加用抗血小板药物阿司匹林,利伐沙班组在常规治疗基础上加用抗凝药物利伐沙班。比较两组的治疗总有效率;比较治疗前和治疗3个月后两组的凝血功能指标[D-二聚体(D-D)、凝血酶原时间(PT)、血小板计数(PLT)]、血液流变学指标[低切全血黏度(LBV)、红细胞变形指数(DI)、血浆黏度(PV)]、MoCA评分变化;比较两组治疗期间栓塞、出血发生情况及其他不良反应事件的发生率。结果:利伐沙班组治疗总有效率高于阿司匹林组,差异有统计学意义(P<0.05);治疗3个月后,两组血清D-D、LBV、DI和PV均显著下降,且利伐沙班组低于阿司匹林组,差异有统计学意义(P<0.05);两组PT及MoCA评分均显著升高,且利伐沙班组高于阿司匹林组,差异有统计学意义(P<0.05)。治疗期间,两组相关不良反应及栓塞、出血事件发生率比较,差异无统计学意义(P>0.05)。结论:阿司匹林与利伐沙班对NVAF合并MCI患者血液高凝状态、认知功能改善效果及用药安全性均属良好,其中利伐沙班疗效更佳,可在临床推广应用。

Objective:To compare the effects of Aspirin and Rivaroxaban in the treatment of patients with non-valvular atrial fibrillation(NVAF)complicated with mild cognitive impairment(MCI).Method:A total of 86 patients with NVAF complicated with MCI who were treated in Department of Cardiology of the First Affiliated Hospital of Hengyang Medical School,University of South China from April 2020 to January 2022 were selected as the study subjects,and they were divided into Aspirin group and Rivaroxaban group by the random number table method,43 cases in each groups.Both groups of patients were given routine treatment for 3 months such as relieving symptoms and protecting cardiac function,and the Aspirin group was additionally given antiplatelet drug Aspirin on the basis of routine treatment,and the Rivaroxaban group was given anticoagulant drug Rivaroxaban on the basis of routine treatment.The total effective rate of of the two groups was compared.The coagulation function indicators[D-dimer(D-D),prothrombin time(PT),platelet count(PLT)]and hemorheological indicators[low shear whole blood viscosity(LBV),erythrocyte deformability index(DI),plasma viscosity(PV)]and Montreal cognitive assessment(MoCA)score before treatment and after 3 months of treatment were compared between the two groups.The occurrence of embolism and bleeding and incidence rates of other adverse reactions during treatment in the two groups were compared.Result:The total effective rate of treatment in the Rivaroxaban group was higher than that in the Aspirin group,the difference was statistically significant(P<0.05).After 3 months of treatment,serum D-D,LBV,DI and PV in the two groups were lower than those before treatment,and the indexes in the Rivaroxaban group were lower than those in the Aspirin group,the differences were statistically significant(P<0.05).The PT and MoCA scores in the two groups were higher than those before treatment,and the indexes in the Rivaroxaban group were higher than those in the Aspirin group,the differences were statistically significant(P<0.05).During treatment,there were no significant differences in the incidence rates of adverse reactions,embolism and bleeding events between the two groups(P>0.05).Conclusion:Aspirin and Rivaroxaban have good improvement effects on hypercoagulability,cognitive function and good medication safety in patients with NVAF complicated with MCI,and Rivaroxaban has better efficacy and can be widely used in clinical practice.