非瓣膜性房颤患者应用利伐沙班与华法林抗凝治疗对预防房颤脑卒中的效果比较

Comparison of Rivaroxaban and Warfarin Anticoagulant Therapy in the Prevention of Atrial Fibrillation Stroke in Patients with Non Valvular Atrial Fibrillation

目的:比较非瓣膜性房颤(NVAF)患者给予利伐沙班与华法林进行抗凝治疗对房颤脑卒中的预防效果。方法:选取2020年1月-2022年5月景德镇市第二人民医院收治的共计84例NVAF患者,按照随机数字表法分成观察组(n=42)与对照组(n=42),对照组采用华法林治疗,观察组采用利伐沙班治疗,两组均治疗2个月。对两组临床疗效、凝血功能指标、房颤脑卒中发生风险及不良事件发生情况进行比较。结果:观察组治疗总有效率(97.62%)较对照组(85.71%)更高(P<0.05);治疗后两组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)均延长(P<0.05),纤维蛋白原(FIB)均降低(P<0.05),与对照组比较,观察组APTT、PT、TT均更长(P<0.05),FIB更低(P<0.05);治疗后两组房颤患者中风风险评估系统(CHADS2)评分均降低(P<0.05),观察组评分较对照组更低(P<0.05);观察组不良事件发生率(9.52%)较对照组(26.19%)更低(P<0.05)。结论:相较于华法林,利伐沙班用于治疗NVAF能够提高临床效果,改善患者凝血功能,增强抗凝效果,其安全性较高,能够降低房颤脑卒中发生风险,预防不良事件发生。

Objective:To compare the effect of Rivaroxaban and Warfarin on the prevention of atrial fibrillation stroke in patients with non valvular atrial fibrillation(NVAF).Method:A total of 84 patients with NVAF admitted to the Second People's Hospital of Jingdezhen from January 2020 to May 2022 were selected and divided into the observation group(n=42)and the control group(n=42)according to the random number table method.The control group was treated with Warfarin,and the observation group was treated with Rivaroxaban,both groups were treated for 2 months.The clinical efficacy,coagulation function indicators,the risk of atrial fibrillation stroke,and the incidence of adverse events of the two groups were compared.Result:The total effective rate of the observation group(97.62%)was higher than 85.71%of the control group(P<0.05).After treatment,the activated partial thromboplastin time(APTT),prothrombin time(PT)and thrombin time(TT)in the two groups were prolonged(P<0.05),and fibrinogen(FIB)was decreased(P<0.05).Compared with the control group,APTT,PT,TT in the observation group were longer(P<0.05),and FIB was lower(P<0.05).After treatment,the stroke risk assessment system(CHADS2)scores of patients with atrial fibrillation in the two groups were decreased(P<0.05),and the score in the observation group was lower than that in the control group(P<0.05).The incidence of adverse events in the observation group(9.52%)was lower than 26.19%in the control group(P<0.05).Conclusion:Compared with Warfarin,Rivaroxaban can improve clinical efficacy,improve coagulation function and enhance anticoagulation effect in the treatment of NVAF.Its safety is high,and it can reduce the risk of atrial fibrillation stroke and prevent adverse events.