不同抗栓方案治疗冠心病房颤患者的效果分析

Effect Analysis of Different Antithrombotic Regimens in the Treatmentof Coronary Heart Disease Patients with Atrial Fibrillation

目的:分析不同抗栓方案对我院冠心病房颤患者的治疗效果及安全性。方法:选取我院2021年3月—2022年3月收治的冠心病房颤患者80例作为本次研究对象。根据不同治疗方案分为对照组和实验组,每组40例。对照组采用硫酸氯吡格雷及华法林二联抗栓治疗;实验组在对照组基础上联用阿司匹林肠溶缓释片,接受三联抗栓治疗。比较两组心功能指标[左室收缩末期内径(LVESD)和左室射血分数(LVEF)]、凝血指标[国际标准化比值(international normalized ratio,INR)、凝血酶原时间[(prothrombin time,PT)]、风险评估指标、不良事件及出血事件发生率、依从性。结果:治疗后,实验组LVESD小于对照组,LVEF大于对照组(P<0.05);实验组脑卒中风险评分、出血风险评分低于对照组(P<0.05);实验组INR、PT高于对照组(P<0.05);实验组不良事件发生率、出血事件发生率与对照组比较,差异无统计学意义(P>0.05);实验组总依从率高于对照组(P<0.05)。结论:在冠心病房颤患者中采取三联抗栓治疗具有较好的临床治疗效果,可有效改善患者心功能和临床症状,不良反应少,患者依从性好及安全性高,值得临床应用。

Objective:To analyze the therapeutic effect and safety of different antithrombotic regimens in patients with coronary heart disease and atrial fibrillation in our hospital.Methods:A total of 80 patients with coronary heart disease and atrial fibrillation admitted to our hospital from March 2021 to March 2022 were selected as the subjects of this study.According to different treatment options were divided into control group and experimental group,with 40 cases in each group.The control group was treated with clopidogrel sulfate and warfarin dual antithrombotic therapy;the experimental group received triple antithrombotic therapy combined with aspirin enteric-coated sustained-release tablets on the basis of the control group.Cardiac function indexes[left ventricular end systolic diameter(LVESD)and left ventricular ejection fraction(LVEF)],coagulation indexes[international normalized ratio(INR),prothrombin time(PT)],risk assessment indexes,incidence of adverse events and bleeding events,compliance were compared between the two groups.Results:After treatment,LVESD in the experimental group was smaller than that in the control group,and LVEF was larger than that in the control group(P<0.05).The scores of stroke risk and bleeding risk in the experimental group were lower than those in the control group(P<0.05).INR and PT in the experimental group were higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse events and bleeding events between the experimental group and the control group(P>0.05).The total compliance rate of the experimental group was higher than that of the control group(P<0.05).Conclusion:Triple antithrombotic therapy has a good clinical effect in patients with coronary heart disease and atrial fibrillation,which can effectively improve the cardiac function and clinical symptoms of patients,with less adverse reactions,good patient compliance and high safety.It is worthy of clinical application.