老年非瓣膜性心房颤动患者临床应用达比加群酯的疗效分析

Effect of dabigatran etexilate in elderly patients with non-valvular atrial fibrillation

目的 调查老年非瓣膜性房颤患者达比加群酯的临床应用情况。方法 收集扬州大学附属苏北人民医院2021年1月—2022年6月心内科使用达比加群酯的老年非瓣膜性房颤患者的信息,根据相关指南对临床应用、实验室指标、临床结局等情况进行统计分析。结果 150例患者中,无适应证用药14例,禁忌证12例;给药剂量不足93例,给药剂量过大9例,给药频次不合理13例,与其他抗凝药物转换不合理20例。实验室指标显示,服药1、3、6个月后活化部分凝血酶原时间(APTT)升高,差异有统计学意义(P<0.05)。临床结局显示,缺血性卒中事件发生率为3.33%(4/120),大出血发生率为1.67%(2/120),脑出血事件发生率为0.83%(1/120)。结论 本院达比加群酯的临床应用以给药剂量不足最为常见。药师应注重老年患者达比加群酯的规范应用。

Objective To investigate the clinical application of dabigatran etexilate in elderly patients with non-valvular atrial fibrillation.Methods Clinical materials of elderly non-valvular atrial fibrillation patients with dabigatran etexilate in the Department of Cardiology of the Subei People′s Hospital Affiliated to Yangzhou University from January 2021 to June 2022 were collected,and according to the relevant guidelines,clinical application,laboratory indicators and clinical outcomes were statistically analyzed.Results Among 150 patients,14 cases had no indications for medication and 12 cases had contraindication;93 cases had insufficient dosage,9 cases had excessive dosage,13 cases had unreasonable frequency of administration,and 20 cases had unreasonable conversion with other anticoagulant drugs.Laboratory indicators indicated a significant increase trend in activated partial prothrombin time(APTT) after 1 month,3 and 6 months of medication(P<0.05).Clinical outcome showed that the incidence of ischemic stroke events was 3.33%(4/120),the incidence of massive bleeding was 1.67%(2/120),and the incidence of cerebral hemorrhage events was 0.83%(1/120).Conclusion It is common that clinical dosage of dabigatran etexilate in our hospital is insufficient.Pharmacists should pay attention to the standardized application of dabigatran etexilate in elderly patients.