利伐沙班和华法林用于房颤患者导管消融术围术期的效果比较
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摘要
目的比较利伐沙班和华法林用于房颤患者导管消融围术期的临床效果。方法选取2016年5月～2017年5月我院收治的72例行导管消融手术治疗的房颤患者作为研究对象,根据抗凝治疗方法的不同,将患者分成对照组和研究组,每组各36例。对照组患者在围术期间给予华法林抗凝治疗,研究组患者给予利伐沙班抗凝治疗。比较两组患者治疗前后的血红蛋白(Hb)、血小板(PLT)水平、国际标准化比值(INR)以及治疗后出血事件发生率、不良反应发生率、房颤复发率。结果两组患者治疗前后的Hb、PLT、INR比较,差异均无统计学意义(P>0.05);两组患者治疗后的Hb、PLT、INR与治疗前比较,差异无统计学意义(P>0.05)。研究组患者治疗后的出血事件发生率、抗凝治疗期间不良反应总发生率均明显低于对照组,差异有统计学意义(P<0.05);两组患者的房颤复发率比较,差异无统计学意义(P>0.05)。结论对房颤患者导管消融围术期间应用利伐沙班和华法林治疗,均具有良好的抗凝功效,但利伐沙班治疗患者术后的出血事件和其他不良事件发生率更低,因此,其治疗的安全性更高。
Objective To compare the clinical effect of Rivaroxaban and Warfarin for catheter ablation in patients with atrial fibrillationduring the perioperative period. Methods A total of 72 patients with atrial fibrillation who underwent catheter ablation in our hospital from May 2016 to May 2017 were selected as subjects. The patients were divided into control group and study group according to anticoagulant therapy. Each group consisted of 36 patients. During the perioperative period, the control group received Warfarin anticoagulant therapy and the study group received Rivaroxaban anticoagulant therapy. The levels of hemoglobin(Hb), platelet(PLT) and international normalized ratio(INR) before and after treatment were compared between the two groups. The incidence of post-treatment bleeding events, the incidence of adverse reactions, and the recurrence rate of atrial fibrillation were compared between the two groups. Results There were no significant differences in Hb, PLT, and INR between the two groups before and after treatment(P>0.05). There was no statistically significant difference in Hb, PLT, and INR between the two groups after treatment and before treatment(P>0.05). There was no significant difference between the two groups before and after treatment(P>0.05). The total incidence of bleeding after treatment and the total incidence of adverse reactions during anticoagulation were significantly lower in the study group than those in the control group, and the differences were statistically significant(P<0.05). There was no significant difference in the recurrence rate of atrial fibrillation between the two groups(P>0.05).Conclusion During the perioperative period, the use of Rivaroxaban and Warfarin for patients with atrial fibrillation who were undergoing catheter ablation has good anticoagulant effects. But the incidence of postoperative bleeding and other adverse events was lower in patients treated with Rivaroxaban. Therefore, this treatment has higher safety.
Objective To compare the clinical effect of Rivaroxaban and Warfarin for catheter ablation in patients with atrial fibrillationduring the perioperative period. Methods A total of 72 patients with atrial fibrillation who underwent catheter ablation in our hospital from May 2016 to May 2017 were selected as subjects. The patients were divided into control group and study group according to anticoagulant therapy. Each group consisted of 36 patients. During the perioperative period, the control group received Warfarin anticoagulant therapy and the study group received Rivaroxaban anticoagulant therapy. The levels of hemoglobin(Hb), platelet(PLT) and international normalized ratio(INR) before and after treatment were compared between the two groups. The incidence of post-treatment bleeding events, the incidence of adverse reactions, and the recurrence rate of atrial fibrillation were compared between the two groups. Results There were no significant differences in Hb, PLT, and INR between the two groups before and after treatment(P>0.05). There was no statistically significant difference in Hb, PLT, and INR between the two groups after treatment and before treatment(P>0.05). There was no significant difference between the two groups before and after treatment(P>0.05). The total incidence of bleeding after treatment and the total incidence of adverse reactions during anticoagulation were significantly lower in the study group than those in the control group, and the differences were statistically significant(P<0.05). There was no significant difference in the recurrence rate of atrial fibrillation between the two groups(P>0.05).Conclusion During the perioperative period, the use of Rivaroxaban and Warfarin for patients with atrial fibrillation who were undergoing catheter ablation has good anticoagulant effects. But the incidence of postoperative bleeding and other adverse events was lower in patients treated with Rivaroxaban. Therefore, this treatment has higher safety.
引文
[1]周宏喜.利伐沙班与华法林对心房颤动消融术后的抗栓效果比较[J].中国乡村医药,2018,25(8):7-8.
[2]赵荣诚,韩佳,付金玲.三种不同抗凝方式用于心房颤动导管消融术患者中的临床效果及经济成本对比分析[J]解放军预防医学杂志,2018,36(2):191-193.
[3]郑黎晖,樊晓寒,陈刚,等.心房颤动导管消融术应用利伐沙班-华法林桥接抗凝治疗一例[J].中国循环杂志,2017,32(11):1123.
[4]孙劼,冯力,冯涛,等.阵发性心房颤动射频消融术后利伐沙班和华法林抗凝治疗的临床效果分析[J].河南医学研究,2017,26(11):1979-1980.
[5]孙飞龙,赵庆春,汤雨虹,等.心房颤动患者导管射频消融术后利伐沙班抗凝治疗的回顾分析[J].中国药师,2017,20(1):124-126.
[6]张萍,张虹.利伐沙班在房颤患者抗凝治疗中的应用研究进展[J].山东医药,2016,56(48):109-112.
[7]Tanvi,Saxena V,Singh A,et al.Improved performance of dye sensitized solar cell via fine tuning of ultra-thin compact TiO2layer[J].Sol Ene Mat and Sol Cel,2017,(170):127-136.
[8]朱锦富,唐义虎,吴延虎.心房颤动射频消融术后多种药物抗凝治疗的临床对比研究[J].南京医科大学学报(自然科学版),2016,36(11):1356-1358.
[9]唐艺加.心房颤动患者射频消融术后利伐沙班抗凝效果观察[J].血栓与止血学,2016,22(2):144-146,150.
[10]王蕊,张文勇,王伟.利伐沙班与华法林用于心房颤动导管消融术后抗凝疗效对比[J].中国循证心血管医学杂志,2016,8(4):492-493,502.
[11]哈斯高娃.利伐沙班防治房颤患者脑卒中43例临床评价[J].中国药业,2016,25(6):42-44.
[12]王汝朋,杨水祥.利伐沙班和达比加群酯及华法林在非瓣膜性心房颤动患者抗凝治疗的研究[J].中华老年心脑血管病杂志,2015,17(12):1246-1249.
[13]姜述斌,姜海兵,李岚,等.利伐沙班与华法林预防心房颤动导管消融术后血栓事件的对比研究[J].中国心脏起搏与心电生理杂志,2015,29(5):458-461.
[14]王璇,刘婧,王祖禄,等.利伐沙班用于心房颤动导管消融术后抗凝治疗有效性及安全性[J].心脏杂志,2016,28(1):33-36.
[15]李群,陆首玲,刘尚,等.华法林和利伐沙班治疗心房颤动临床疗效对比分析[J].内科,2015,10(4):463-465.
[16]李秀芬,葛振嵘,帕尔哈提·吐尔逊.利伐沙班与华法林治疗左心室心尖部血栓的疗效比较[J].中国循环杂志,2015,30(6):559-561.
[17]刘维国.老年心房颤动的华法林抗凝治疗[J].中国当代医药,2009,16(6):50.
[18]杨平.利伐沙班与华法林对非瓣膜性房颤预防血栓栓塞128例疗效观察[J].中国煤炭工业医学杂志,2015,18(1):14-16.
[19]吕程,何燕,许键,等.利伐沙班与华法林对心房颤动伴左心房血栓形成患者的疗效观察[J].中国循环杂志,2016,31(11):1098-1101.
[20]章玲,李军,麦爱欢,等.心房颤动射频消融术后利伐沙班和华法林抗凝治疗对比研究[J].中华临床医师杂志(电子版),2015,9(12):2404-2406.
[2]赵荣诚,韩佳,付金玲.三种不同抗凝方式用于心房颤动导管消融术患者中的临床效果及经济成本对比分析[J]解放军预防医学杂志,2018,36(2):191-193.
[3]郑黎晖,樊晓寒,陈刚,等.心房颤动导管消融术应用利伐沙班-华法林桥接抗凝治疗一例[J].中国循环杂志,2017,32(11):1123.
[4]孙劼,冯力,冯涛,等.阵发性心房颤动射频消融术后利伐沙班和华法林抗凝治疗的临床效果分析[J].河南医学研究,2017,26(11):1979-1980.
[5]孙飞龙,赵庆春,汤雨虹,等.心房颤动患者导管射频消融术后利伐沙班抗凝治疗的回顾分析[J].中国药师,2017,20(1):124-126.
[6]张萍,张虹.利伐沙班在房颤患者抗凝治疗中的应用研究进展[J].山东医药,2016,56(48):109-112.
[7]Tanvi,Saxena V,Singh A,et al.Improved performance of dye sensitized solar cell via fine tuning of ultra-thin compact TiO2layer[J].Sol Ene Mat and Sol Cel,2017,(170):127-136.
[8]朱锦富,唐义虎,吴延虎.心房颤动射频消融术后多种药物抗凝治疗的临床对比研究[J].南京医科大学学报(自然科学版),2016,36(11):1356-1358.
[9]唐艺加.心房颤动患者射频消融术后利伐沙班抗凝效果观察[J].血栓与止血学,2016,22(2):144-146,150.
[10]王蕊,张文勇,王伟.利伐沙班与华法林用于心房颤动导管消融术后抗凝疗效对比[J].中国循证心血管医学杂志,2016,8(4):492-493,502.
[11]哈斯高娃.利伐沙班防治房颤患者脑卒中43例临床评价[J].中国药业,2016,25(6):42-44.
[12]王汝朋,杨水祥.利伐沙班和达比加群酯及华法林在非瓣膜性心房颤动患者抗凝治疗的研究[J].中华老年心脑血管病杂志,2015,17(12):1246-1249.
[13]姜述斌,姜海兵,李岚,等.利伐沙班与华法林预防心房颤动导管消融术后血栓事件的对比研究[J].中国心脏起搏与心电生理杂志,2015,29(5):458-461.
[14]王璇,刘婧,王祖禄,等.利伐沙班用于心房颤动导管消融术后抗凝治疗有效性及安全性[J].心脏杂志,2016,28(1):33-36.
[15]李群,陆首玲,刘尚,等.华法林和利伐沙班治疗心房颤动临床疗效对比分析[J].内科,2015,10(4):463-465.
[16]李秀芬,葛振嵘,帕尔哈提·吐尔逊.利伐沙班与华法林治疗左心室心尖部血栓的疗效比较[J].中国循环杂志,2015,30(6):559-561.
[17]刘维国.老年心房颤动的华法林抗凝治疗[J].中国当代医药,2009,16(6):50.
[18]杨平.利伐沙班与华法林对非瓣膜性房颤预防血栓栓塞128例疗效观察[J].中国煤炭工业医学杂志,2015,18(1):14-16.
[19]吕程,何燕,许键,等.利伐沙班与华法林对心房颤动伴左心房血栓形成患者的疗效观察[J].中国循环杂志,2016,31(11):1098-1101.
[20]章玲,李军,麦爱欢,等.心房颤动射频消融术后利伐沙班和华法林抗凝治疗对比研究[J].中华临床医师杂志(电子版),2015,9(12):2404-2406.