利伐沙班在治疗老年非瓣膜性房颤中临床效果及安全性观察

Clinical efficacy and safety of rivaroxaban in treatment of senile nonvalvular atrial fibrillation

目的探究利伐沙班在老年非瓣膜性房颤治疗中的临床效果及安全性。方法选择2019年2月—2022年2月本院收治的老年非瓣膜性房颤患者82例,按随机数字表法1∶1分配,各41例。对照组采用华法林治疗,观察组予以利伐沙班治疗,均持续治疗3个月。比较2组凝血指标、血栓栓塞事件及出血性事件发生情况。结果治疗前、治疗后,2组凝血指标比较,差异无统计学意义(P>0.05)。治疗后,2组凝血原酶时间(PT)、活化部分凝血原酶时间(APTT)、凝血酶时间(TT)水平均高于治疗前(t=7.483、6.473、10.073、7.711、4.940、3.519,P均<0.001),纤维蛋白原(FIB)、D-二聚体(D-D)、血小板计数(PLT)水平均低于治疗前,差异有统计学意义(t=10.260、8.361、19.677、15.066、21.327、18.711,P均<0.001)。2组血栓栓塞事件和出血性事件发生率差异均无统计学意义(P>0.364)。结论利伐沙班治疗老年非瓣膜性房颤患者在改善凝血功能、降低血栓栓塞事件发生风险方面效果与华法林相似,在预防出血性事件发生方面相对更好,临床需根据实际情况合理用药。

Objective To explore the clinical effect and safety of rivaroxaban in the treatment of senile nonvalvular atrial fibrillation.Methods A total of 82 elderly patients with nonvalvular atrial fibrillation admitted to our hospital from February 2019 to February 2022 were selected and randomly assigned 1∶1 by using a random number table method,with 41 patients in each group.The control group was treated with warfarin,and the observation group was treated with rivaroxaban for 3 months.The occurrence of coagulation indicators,thromboembolic events,and hemorrhagic events were compared between the two groups.Results There was no statistically significant difference in coagulation indicators between the two groups before and after treatment(P>0.05).After treatment,the levels of prothrombin time(PT),activated partial prothrombin time(APTT),and thrombin time(TT)in both groups were higher than those before treatment(t=7.483,6.473,10.073,7.711,4.940,3.519,all P<0.001),while the levels of fibrinogen(FIB),D-dimer(D-D),and platelet count(PLT)were lower than those before treatment,and the differences were statistically significant(t=10.260,8.361,19.677,15.066,21.327,18.711,all P<0.001).There was no statistically significant difference in the incidence of thromboembolic and hemorrhagic events between the two groups(P>0.364).Conclusions Rivaroxaban is similar to warfarin in improving blood coagulation function and reducing the risk of thromboembolic events in elderly patients with nonvalvular atrial fibrillation,but it is better in preventing hemorrhagic events.It should be used rationally according to the actual situation.