新型口服抗凝药物治疗高龄非瓣膜性房颤患者的疗效探讨

Efficacy of new oral anticoagulants in the treatment of nonvalvular atrial fibrillation in the elderly

目的观察高龄非瓣膜性心房颤动(房颤)患者采用新型口服抗凝药物治疗的有效性。方法236例高龄非瓣膜性房颤患者,随机分为普通治疗组与抗凝治疗组,每组118例。普通治疗组接受普通药物治疗,抗凝治疗组接受新型口服抗凝药物治疗。比较两组患者治疗前后的凝血功能指标(凝血酶原时间、凝血酶时间、纤维蛋白原、活化部分凝血活酶时间),不良事件发生情况,栓塞事件发生情况。结果治疗后,两组患者的凝血酶原时间、凝血酶时间、活化部分凝血活酶时间长于本组治疗前,纤维蛋白原低于本组治疗前,且抗凝治疗组患者的凝血酶原时间(13.72±2.11)s、凝血酶时间(13.27±1.44)s、活化部分凝血活酶时间(38.44±0.56)s长于普通治疗组的(11.42±2.52)、(11.67±2.52)、(34.52±1.76)s,纤维蛋白原(3.76±0.42)g/L低于普通治疗组的(4.11±1.50)g/L,差异具有统计学意义(P<0.05)。抗凝治疗组不良事件发生率5.1%低于普通治疗组的12.7%,差异具有统计学意义(P<0.05)。抗凝治疗组栓塞事件发生率4.2%低于普通治疗组的11.9%,差异具有统计学意义(P<0.05)。结论高龄非瓣膜性房颤患者采用新型口服抗凝药物治疗,可以更好地调整患者凝血功能,降低不良事件和栓塞的发生率,临床可以推广应用。

Objective To observe the effectiveness of new oral anticoagulants in the treatment of nonvalvular atrial fibrillation in the elderly.Methods A total of 236 elderly patients with nonvalvular atrial fibrillation were randomly divided into general treatment group and anticoagulation treatment group,with 118 cases in each group.The general treatment group received common drugs,and the anticoagulant treatment group received oral new anticoagulant drugs.Both groups were compared in terms of indexes of coagulation function(prothrombin time,thrombin time,fibrinogen,activated partial thromboplastin time)before and after treatment,occurrence of adverse events,and embolization events.Results After treatment,the prothrombin time,thrombin time and activated partial thromboplastin time in both groups were longer than those before treatment in this group,while the fibrinogen was lower than that before treatment in this group;in anticoagulant treatment group,the prothrombin time was(13.72±2.11)s,the thrombin time was(13.27±1.44)s and the activated partial thromboplastin time was(38.44±0.56)s,which were longer than those of(11.42±2.52),(11.67±2.52)and(34.52±1.76)s in general treatment group;the fibrinogen of(3.76±0.42)g/L in anticoagulant treatment group was lower than that of(4.11±1.50)g/L in general treatment group;the differences were statistically significant(P<0.05).The incidence of adverse events in the anticoagulant treatment group was 5.1%,which was lower than that of 12.7% in the general treatment group,and the difference was statistically significant(P<0.05).The incidence of embolism events in the anticoagulant treatment group was 4.2%,which was lower than that of 11.9% in the general treatment group,and the difference was statistically significant(P<0.05).Conclusion New oral anticoagulants for elderly patients with nonvalvular atrial fibrillation can better adjust the coagulation function of patients and reduce the incidence of adverse events and embolism,which can be promoted and applied in clinical practice.