不同抗凝药物在高龄冠心病合并非瓣膜性房颤患者中的应用对比分析
Comparative Analysis of Different Anticoagulants in Elderly Patients with Coronary Heart Disease and Non-Valvular Atrial Fibrillation
田媛媛1
作者信息
- 1. 河南省胸科医院 药学部,河南 郑州 450000
- 折叠
摘要
目的 探究常用抗凝药物利伐沙班和华法林在高龄冠心病合并非瓣膜性房颤患者抗凝治疗中的疗效与安全性差异.方法 选取河南省胸科医院 2022 年 1 月至 2024 年 1 月收治的 60 例高龄冠心病合并非瓣膜性房颤患者,随机分为对照组和研究组.两组患者均予以常规冠心病等药物治疗,对照组联合使用华法林进行抗凝治疗,研究组联合使用利伐沙班进行抗凝治疗.治疗 12 周后,比较两组患者治疗前后肝肾功能水平和凝血功能变化;同时比较两组患者治疗过程中出现的不良事件情况以及接受治疗 6 个月内的疗效终点事件差异.结果 治疗前后,两组患者的丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、血肌酐(Scr)和尿素氮(BUN)检测结果比较,差异均无统计学意义(P＞0.05).比较组内治疗前后各指标变化,对照组治疗后ALT较本组治疗前明显增加,差异具有统计学意义(P＜0.05);对照组患者其余指标及研究组患者肝肾功能所有指标的组内比较,差异均无统计学意义(P＞0.05).治疗前后,两组患者的血浆凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)和活化部分凝血活酶时间(APTT)检测结果比较,差异均无统计学意义(P＞0.05).比较组内治疗前后各指标变化,可见两组患者治疗后PT、TT和APTT检测结果,均明显高于治疗前,差异均有统计学意义(P＜0.05),而FIB则显著低于治疗前,差异具有统计学意义(P＜0.05).对照组患者治疗期间不良反应事件发生率(33.33%)明显高于研究组(6.67%),差异具有统计学意义(P＜0.05).两组患者的疗效终点事件发生率比较差异无统计学意义(P＞0.05).结论 在常规治疗基础上应用利伐沙班和华法林对高龄冠心病合并非瓣膜性房颤患者的抗凝作用效果相似,同时两种药物对患者肝肾功能的影响效果对比无明显差异.相比之下,利伐沙班的不良反应发生率,尤其是出血事件的临床发生率显著低于华法林,值得临床应用.
Abstract
Objective To explore the differences in efficacy and safety between the commonly used anticoagulants rivaroxaban and warfarin in elderly patients with coronary heart disease and non-valvular atrial fibrillation.Methods A total of 60 elderly patients with coronary heart disease and non-valvular atrial fibrillation admitted to Henan Provincial Chest Hospital from January 2022 to January 2024 were randomly divided into a control group and a study group.Both groups received conventional treatment for coronary heart disease;the control group was additionally treated with warfarin for anticoagulation,while the study group received rivaroxaban.After 12 weeks of treatment,changes in liver and kidney function and coagulation function levels were compared between the two groups.Adverse events during treatment and efficacy endpoint events occurring within six months of treatment were also compared.Results There were no statistically significant differences in alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum creatinine(Scr),and blood urea nitrogen(BUN)levels between the two groups before and after treatment(P＞0.05).However,in the control group,ALT significantly increased post-treatment compared to pre-treatment,with a statistically significant difference(P＜0.05).There were no significant differences in liver and kidney function indicators in the remaining comparisons between the control group and all indicators in the study group(P＞0.05).Post-treatment plasma prothrombin time(PT),thrombin time(TT),fibrinogen(FIB),and activated partial thromboplastin time(APTT)were compared between the two groups,showing no significant differences(P＞0.05).Within-group comparisons revealed that PT,TT,and APTT levels were significantly higher after treatment compared to before treatment in both groups(P＜0.05),while FIB levels were significantly lower(P＜0.05).The incidence of adverse reaction events in the control group(33.33%)was significantly higher than in the study group(6.67%),with a statistically significant difference(P＜0.05).There were no significant differences in the incidence of efficacy endpoint events between the two groups(P＞0.05).Conclusion Rivaroxaban and warfarin have similar anticoagulant effects in elderly patients with coronary heart disease and non-valvular atrial fibrillation when used in conjunction with conventional treatment.Both drugs have similar effects on liver and kidney function.However,rivaroxaban demonstrated a significantly lower incidence of adverse reactions,especially bleeding events,compared to warfarin,making it a valuable option for clinical application.
关键词
冠心病/非瓣膜性房颤/利伐沙班/华法林/临床疗效/安全性Key words
coronary heart disease/non-valvular atrial fibrillation/Rivaroxaban/Warfarin/clinical efficacy/safety引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据