【摘要】 目的比较利伐沙班与华法林在高龄持续性心房颤动患者中的应用效果。方法将本院接受治疗的高龄持续性心房颤动患者120例分为2组,均接受常规治疗。利伐沙班组(60例)加用利伐沙班治疗,华法林组(60例)加用华法林治疗。对比2组患者治疗前、治疗2个月后凝血功能、N末端B型利钠肽前体(NT-proBNP)、简易智力状态检查(MMSE)量表评分、日常生活能力(ADL)量表评分、栓塞、出血以及死亡的发生情况。结果治疗2个月后,2组患者D-二聚体水平(D-D)、活化部分凝血酶原时间(APTT)、凝血酶原时间(PT)及NT-proBNP均改善,但差异无统计学意义(P> 0. 05); 2个月后,2组MMSE、ADL评分比较差异无统计学意义(P> 0. 05);治疗期间,利伐沙班组栓塞率、病死率与华法林组比较差异无统计学意义(P> 0. 05);利伐沙班组出血率低于华法林组,差异有统计学意义(P <0. 05)。结论利伐沙班与华法林在控制高龄持续性心房颤动患者的凝血功能、NT-proBNP指标及改善智力状态、生活能力等方面药效相似,但利伐沙班能够降低患者治疗期间的出血率。更多还原

【Abstract】 Objective To compare the effect of rivaroxaban and warfarin in treating senile patients with persistent atrial fibrillation. Methods A total of 120 senile patients with persistent atrial fibrillation treated in the hospital were divided into two groups,receiving routine treatment. Rivaroxaban group( 60 cases) was given rivaroxaban,and warfarin group( 60 cases) was additionally treated with warfarin. The coagulation function,N terminal pro-B-type natriuretic peptide( NT-proBNP),Mini-mental State Examination( MMSE),Activity of Daily Living( ADL),incidences of embolism,bleeding,death before treatment and after treatment for 2 months were compared between two groups. Results After 2-month treatment,the D-dimer( D-D),activated partial thromboplastin time( APTT),prothrombin time( PT) and NT-proBNP in two groups improved,but showed no significant difference( P > 0. 05); the MMSE scores increased,and the ADL scores decreased in two groups,but there were no significant between-group differences( P > 0. 05); there was no statistical difference in the rates of embolism and death,as well as mortality rate between rivaroxaban group and warfarin group after 2-month treatment( P > 0. 05); the bleeding rate of rivaroxaban group was lower than that of warfarin group( P < 0. 05). Conclusion Rivaroxaban and warfarin for senile patients with persistent atrial fibrillation have similar effects in controlling coagulation function and NT-proBNP,improving mental state and quality of life. However,rivaroxaban can decrease the bleeding rate during treatment.更多还原