不同抗凝药物治疗高龄非瓣膜性心房颤动患者的效果分析

Analysis of the effect of different anticoagulants in the treatment of non valvular atrial fibrillation in elderly patients

目的评估对高龄非瓣膜性心房颤动(NVAF)患者行不同抗凝药物治疗的效果。方法60例高龄NVAF患者,以电脑法分为一般组和试验组,每组30例。一般组给予华法林治疗,试验组给予利伐沙班治疗。比较两组患者用药前后凝血指标[凝血酶时间(TT)、凝血酶原时间(PT)、国际标准化比值(INR)、活化部分凝血活酶时间(APTT)]、治疗效果、栓塞事件发生情况、出血情况。结果用药后,试验组TT、PT、INR、APTT水平分别为(16.42±4.09)s、(13.05±2.31)s、(2.53±0.31)、(31.83±2.96)s、一般组患者TT、PT、INR、APTT水平分别为(16.89±4.11)s、(13.79±2.49)s、(2.58±0.40)、(31.77±2.55)s,两组患者TT、PT、INR、APTT水平均高于用药前,有统计学差异(P<0.05),但试验组和一般组组间比较无统计学差异(P>0.05)。试验组、一般组治疗总有效率分别为96.67%、90.00%,无统计学差异(P>0.05)。试验组、一般组栓塞事件发生率分别为10.00%、16.67%,无统计学差异(P>0.05)。试验组出血发生率6.67%低于一般组的26.67%,有统计学差异(P<0.05)。结论针对高龄NVAF患者有多种治疗药物,华法林、利伐沙班均有较好作用,可防控栓塞病变,但在出血预防中利伐沙班效果更为明显,建议推广。

Objective To evaluate the effect of different anticoagulant drugs in the treatment of non valvular atrial fibrillation(NVAF)in elderly patients.Methods 60 elderly NVAF patients were divided into a general group and an experimental group by computer method,with 30 cases in each group.The general group was treated with warfarin,and the experimental group was treated with rivaroxaban.Both groups were compared in terms of coagulation indicators[thrombin time(TT),prothrombin time(PT),International Normalized Ratio(INR),activated partial thromboplastin time(APTT)],treatment effect,embolic events,and bleeding.Results After treatment,the levels of TT,PT,INR and APTT in the experimental groups were(16.42±4.09)s,(13.05±2.31)s,(2.53±0.31)and(31.83±2.96)s;the levels of TT,PT,INR and APTT in the general group were(16.89±4.11)s,(13.79±2.49)s,(2.58±0.40)and(31.77±2.55)s.The levels of TT,PT,INR and APTT in both groups were higher than those before treatment,and there was a statistical significance(P<0.05),but there was no statistical significance between the experimental group and the general group(P>0.05).The total effective rate of the experimental group and the general group were 96.67%and 90.00%,and there was no statistical significance(P>0.05).The incidence of embolization events in the experimental group and the general group were 10.00%and 16.67%,and there was no statistical significance(P>0.05).The incidence of bleeding in the experimental group(6.67%)was lower than that in the general group(26.67%),and there was a statistical significance(P<0.05).Conclusion There are several therapeutic drugs for elderly NVAF patients,warfarin and rivaroxaban have better effects in preventing and controlling embolic lesions,but rivaroxaban is more effective in bleeding prevention and is recommended to be promoted.