达比加群与利伐沙班双靶点联合抗凝治疗老年房颤合并卒中的临床观察

Clinical observation of dual-target combined anticoagulation therapy of dabigatran and rivaroxaban in elderly patients with at-rial fibrillation complicated with stroke

中文关键词: 老年  房颤合并卒中  达比加群  利伐沙班  抗凝治疗  凝血功能  出血风险

英文关键词: elderly  atrial fibrillation complicated with stroke  dabigatran  rivaroxaban  anticoagulant therapy  coagula-tion function  risk of bleeding

中文摘要:

      目的 探讨达比加群与利伐沙班双靶点联合抗凝治疗老年房颤合并卒中患者疗效.方法 选择2022年1月—2023年12月绵阳市盐亭县人民医院收治的120例老年房颤合并卒中患者,以随机数表法分为联合抗凝组(n=60,采用达比加群联合利伐沙班治疗)与对照组(n=60,采用达比加群治疗),2组均连续治疗6个月.比较2组凝血功能、肝肾功能、1年内不良事件.结果 治疗后,2组凝血酶原时间(PT)、凝血酶时间(TT)、部分凝血活酶时间(APTT)均多于同组治疗前(P＜0.05),且联合抗凝组上述指标值均高于对照组(P＜0.05).治疗前后比较,2组谷丙转氨酶(ALT)、谷草转氨酶(AST)水平差异均无统计学意义(P＞0.05);治疗后,联合抗凝组肌酐(SCr)升高,且高于对照组(P＜0.05);随访1年,联合抗凝组血栓栓塞总发生率低于对照组(P＜0.05),而出血事件发生率高于对照组(P＜0.05).结论 达比加群与利伐沙班双靶点联合抗凝治疗老年房颤合并卒中,效果良好,可较好改善患者凝血功能,降低血栓栓塞事件发生率,但可能相对增加出血风险.

英文摘要:

      Objective To investigate the efficacy of dual-target combined anticoagulation therapy of dabigatran and ri-varoxaban in elderly patients with atrial fibrillation(AF)complicated with stroke.Methods 120 elderly AF patients with stroke admitted to People's Hospital of Yanting County from January 2022 to December 2023 were selected and randomly divid-ed into combined anticoagulation group(n=60,treated with dabigatran combined with rivaroxaban)and control group(n=60,treated with dabigatran)by a random number table method.Both groups were treated continuously for 6 months.The co-agulation function,liver and kidney function,and adverse events within one year were compared between the two groups.Results After treatment,the prothrombin time(PT),thrombin time(TT),and partial thromboplastin time(APTT)in both groups were longer than those in the same group before treatment(P＜0.05),and the combined anticoagulation group was lon-ger than the control group(P＜0.05).Before and after treatment,there was no statistically significant difference in the levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)between the two groups(P＞0.05).After treat-ment,the creatinine(SCr)level in the combined anticoagulation group increased and was higher than that in the control group(P＜0.05).During the 1-year follow-up,the total incidence of thromboembolism in the combined anticoagulation group was lower than that in the control group(P＜0.05),but the incidence of bleeding events was significantly higher than that in the control group(P＜0.05).Conclusion The dual-target combined anticoagulation therapy of dabigatran and rivaroxaban has a good effect on elderly patients with AF complicated with stroke.It can effectively improve the coagulation function and reduce the incidence of thromboembolic events,but it may relatively increase the risk of bleeding.