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薛琳1,陈炅2▲.达比加群酯与华法林治疗老年非瓣膜性房颤患者的有效性及安全性[J].中国医药科学,2021,(4):35-38        基金项目:
达比加群酯与华法林治疗老年非瓣膜性房颤患者的有效性及安全性
Efficacy and safety of dabigatran etexilate and warfarin in the treatment of elderly patients with nonvalvular atrial fibrillation
  
DOI:
中文关键词:  [关键词] 非瓣膜性房颤;华法林;达比加群酯;有效性;安全性;
英文关键词:[Key words] Nonvalvular atrial fibrillation; Warfarin; Dabigatran etexilate; Efficacy; Safety
作者单位
薛琳1,陈炅2▲ 郑州大学第五附属医院急诊科,河南郑州 450052 
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中文摘要:
      [摘要] 目的 分析比较新型口服抗凝剂(NOACs)达比加群酯与华法林在治疗非瓣膜性房颤患者中的有效性及安全性。 方法 选取郑州大学第五附属医院2019年7月至2020年7月收治的非瓣膜性房颤患者,进行回顾性研究,共120例,接受达比加群酯治疗者60例,设为观察组,接受华法林治疗者60例,设为对照组,观察对比各组在治疗后的凝血指标血浆凝血酶原时间(PT)、国际标准化比值(INR)、凝血酶原活动度(PT%)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)、D-二聚体(DD)、纤维蛋白原降解产物(FDP)、血小板计数(PLT)、血小板平均容积(MPV),及缺血性卒中、出血性卒中、颅外出血、下肢静脉栓塞等、短暂性脑缺血发作(TIA)等不良事件的发生情况。 结果 达比加群酯组PT低于华法林组,PLT高于华法林组,差异有统计学意义(P<0.05);达比加群酯组PT%、APTT、TT、DD低于华法林组;INR、FIB、FDP、MPV高于华法林组,差异无统计学意义(P>0.05)。达比加群酯组出血性卒中、下肢静脉栓塞、颅外出血发生率低于华法林组,下肢静脉栓塞、颅外出血发生率比较,差异无统计学意义(P>0.05);达比加群酯组缺血性卒中、TIA事件高于华法林组缺血性卒中、TIA事件,差异无统计学意义(P>0.05)。 结论 达比加群酯在治疗非瓣膜性房颤中的抗凝效果优于华法林,且不良事件发生率低于华法林,安全性高,值得推广。
英文摘要:
      [Abstract] Objective To analyze and compare the efficacy and safety of new oral anticoagulants (NOACs) dabigatran etexilate and warfarin in the treatment of elderly patients with nonvalvular atrial fibrillation. Methods A total of 120 patients with nonvalvular atrial fibrillation admitted to our hospital from July 2019 to July 2020 were selected for retrospective research, and they were divided into the observation group (n=60) and the control group (n=60). The observation group was treated with dabigatran etexilate, while the control group was treated with warfarin. After treatment, the coagulation indexes such as plasma prothrombin time (PT), international normalized ratio (INR), prothrombin activity (PT%), activated partial thromboplastin time (APTT), fibrinogen (FIB), thrombin time (TT), D-dimer (DD), fibrinogen degradation products (FDP), platelet count (PLT), mean platelet volume (MPV), and adverse events (AEs) such as ischemic stroke, hemorrhagic stroke, extracranial hemorrhage, venous embolism of lower extremities, and transient ischemic attack (TIA) between the two groups were observed and compared. Results PT in the dabigatran etexilate group was lower than that in the warfarin group, and PLT was higher than that in the warfarin group, with statistically significant difference (P < 0.05). The PT%, APTT, TT and DD in the dabigatran etexilate group were lower than those in the warfarin group, with PT%, APT, TT and DD. The levels of INR, FIB, FDP and MPV in the dabigatran etexilate group were higher than those in the warfarin group, with INR, FIB, FDP and MPV, and without statistically significant differences (P > 0.05). The incidences of hemorrhagic stroke, lower extremity venous embolism and extracranial hemorrhage in the dabigatran etexilate group were lower than those in the warfarin group, with hemorrhagic stroke, lower extremity venous embolism and extracranial hemorrhage, and without statistically significant differences (P > 0.05). Ischemic stroke and TIA events in the dabigatran etexilate
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