摘要
目的：探讨达比加群酯对老年持续性房颤患者凝血指标及安全性的影响。方法：将52例老年持续性房颤患者按照随机数字表法分为观察组和对照组,各26例。观察组患者肌酐清除率〉30 ml/min时,口服达比加群酯胶囊110 mg,bid;肌酐清除率为15~30 ml/min时,口服达比加群酯胶囊55 mg,bid。对照组患者口服华法林钠片,初始剂量2.5 mg,qd,3~5 d后根据国际标准化比值（INR）调整剂量,直至INR维持在2.0~3.0。治疗3个月后,比较两组患者治疗前后凝血指标[凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、INR、血小板计数（PLT）、纤维蛋白原（FIB）]、临床事件（脑栓塞、脑出血、致命性出血、其余部位栓塞、死亡）发生率及不良发生发生情况。结果：两组患者治疗前PT、APTT、TT、PLT、FIB比较,差异均无统计学意义（P〉0.05）;治疗后,两组患者PT、INR较治疗前显著改善,且观察组明显优于对照组,差异有统计学意义（P〈0.05）。两组患者均未出现脑出血、致命性出血临床事件;脑栓塞发生率比较,差异无统计学意义（P〉0.05）;观察组患者其余部位栓塞、死亡发生率显著低于对照组,差异有统计学意义（P〈0.05）。观察组患者不良反应发生率显著低于对照组,差异有统计学意义（P〈0.05）。结论：达比加群酯治疗老年持续性房颤的抗凝效果较好,能明显改善患者PT、INR,降低临床事件发生率,且安全性较好。
OBJECTIVE：To explore the effect of dabigatran etexilate on coagulation indexes and safety of elderly patients with persistent atrial fibrillation. METHODS：52 elderly patients with persistent atrial fibrillation were randomly divided into observation group and control group by random number table,26 cases in each group. Creatinine clearance rate in observation group was higher than 30 ml/min,110 mg Dabigatran etexilate capsule was orally given,bid;when 15-30 ml/min,55 mg capsule was orally given,bid. Control group orally received Warfarin sodium tablet with initial dose of 2.5 mg,qd,according to international normalized ratio（INR）after 3-5 days till maintained in 2.0-3.0. After 3 months,coagulation indexes [prothrombin time（PT）,activated partial thromboplastin time（APTT）,thrombin time（TT）,INR,platelet count（PLT）,fibrinogen（FIB）] before and after treatment,incidences of clinical events（cerebral embolism,cerebral hemorrhage,fatal bleeding,the remaining parts of embolism,death）and adverse reactions in 2 groups were compared. RESULTS：There was no significant difference in PT,APTT,TT,PLT and FIB between 2 groups before treatment（P〉0.05）;after treatment,PT and INR in 2 groups significantly increased,and observation group was obviously better than control group,the difference was statistically significant（P〈0.05）. No cerebral hemorrhage or fatal hemorrhage occurred in the two groups. There was no significant difference in the incidence of cerebral embolism between2 groups（P〈0.05）;the incidence of remaining parts of embolism,death in observation group significantly lower than control group,the difference was statistically significant（P〈0.05）. The incidence of adverse reactions in observation group was significantly lower than control group,the difference was statistically significant（P〈0.05）. CONCLUSIONS：Dabigatran etexilate shows good coagulation effect on elderly patients with persistent atrial fibrillation,which can effectively improve PT and INR levels and reduce the incidences of clinical events,with good safety.
出处
《中国药房》
CAS
北大核心
2016年第23期3267-3269,共3页
China Pharmacy
关键词
达比加群酯
华法林
老年患者
持续性房颤
凝血指标
安全性
Dabigatran etexilate
Warfarin
Elderly patients
Persistent atrial fibrillation
Coagulation indexes
Safety
