达比加群酯联合替格瑞洛对老年心房颤动伴不稳定型心绞痛患者凝血功能及心肌指标的影响

Effect of Dabigatran Etexilate Combined with Ticagrelor on Coagulation Function and Myocardial Indicators in Elderly Patients with Atrial Fibrillation and Unstable Angina Pectoris

目的:研究达比加群酯联合替格瑞洛对老年心房颤动伴不稳定型心绞痛患者凝血功能及心肌指标的影响。方法:选取2020年1月—2023年6月厦门大学附属中山医院97例老年心房颤动伴不稳定型心绞痛患者为研究对象,按随机数字表法将其分为研究组(n=49)与对照组(n=48)。对照组行华法林联合替格瑞洛治疗,研究组行达比加群酯联合替格瑞洛治疗,两组均持续治疗12个月。比较两组治疗前后凝血功能[凝血酶时间(TT)、凝血酶原时间(PT)、血浆活化部分凝血酶时间(APTT)、国际标准化比值(INR)]、心肌指标[血浆肌钙蛋白I(troponin I,cTnI)、N端氨基脑钠肽前体(N-terminal pro brain natriuretic peptide,NT-proBNP)、血清脂蛋白(a)],统计两组不良反应发生率。结果:研究组治疗后的TT、PT、APTT、INR均低于对照组,差异均有统计学意义(P<0.05);研究组治疗后的cTnI、NT-proBNP、脂蛋白(a)均低于对照组,差异均有统计学意义(P<0.05);研究组的不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论:相较于华法林联合替格瑞洛方案,达比加群酯联合替格瑞洛方案更加有益于老年心房颤动伴不稳定型心绞痛患者凝血功能的改善,有助于患者心肌损伤的预防,安全性更好。

Objective:To investigate the effects of Dabigatran Etexilate combined with Ticagrelor on coagulation function and myocardial indicators in elderly patients with atrial fibrillation and unstable angina pectoris.Method:A total of 97 elderly patients with atrial fibrillation and unstable angina pectoris at Zhongshan Hospital Affiliated to Xiamen University from January 2020 to June 2023 were selected as the study subjects.They were divided into study group(n=49)and control group(n=48)by random number table method.The control group was treated with Warfarin combined with Ticagrelor,while the study group was treated with Dabigatran Etexilate combined with Ticagrelor.Both groups were treated for 12 months.The coagulation function[thrombin time(TT),prothrombin time(PT),plasma activated partial thromboplastin time(APTT),international normalized ratio(INR)],myocardial indicators[plasma troponin I(cTnI),N-terminal pro brain natriuretic peptide(NT-proBNP),serum lipoprotein(a)]of the two groups before and after treatment were compared.The incidence of adverse reactions in the two groups was analyzed.Result:The TT,PT,APTT and INR of the study group were lower than those of the control group after treatment,the differences were statistically significant(P<0.05).The cTnI,NT-proBNP and lipoprotein(a)levels in the study group were lower than those in the control group after treatment,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Compared with the combination of Warfarin and Ticagrelor,the combination of Dabigatran Etexilate and Ticagrelor is more beneficial for improving coagulation function in elderly patients with atrial fibrillation and unstable angina,helping to prevent myocardial Medical Innovation of China Vol.21,No.33 November,2024 injury,and has better safety.