【摘要】 目的探讨在治疗老年心房颤动合并不稳定型心绞痛时使用达比加群酯联合替格瑞洛对其凝血功能及临床疗效的影响。方法 120例老年心房颤动合并不稳定型心绞痛患者,按照入院的先后顺序分成观察组和对照组,每组60例。对照组在常规治疗的基础上口服华法林、替格瑞洛进行治疗,观察组在常规治疗的基础上加用达比加群酯联合替格瑞洛进行治疗。比较两组治疗前后凝血指标[凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)]及出血情况、不良心血管事件发生情况。结果治疗3、12个月后,两组PT、TT、APTT均长于治疗前,且观察组治疗3个月后的PT、TT、APTT分别为(12.65±0.76)、(14.24±3.11)、(32.25±4.55)s,长于对照组的(11.56±1.85)、(12.66±3.15)、(30.42±4.12)s,治疗12个月后的PT、TT、APTT分别为(13.62±1.32)、(16.65±5.12)、(33.76±5.12)s,长于对照组的(12.55±2.02)、(14.23±7.26)、(31.12±5.87)s,差异有统计学意义(P<0.05)。观察组总出血率3.33%低于对照组的18.33%,差异具有统计学意义(P<0.05)。两组不良心血管事件发生率比较差异无统计学意义(χ2=0, P>0.05)。结论老年心房颤动合并不稳定型心绞痛时采用达比加群酯联合替格瑞洛治疗效果理想,能够预防血栓形成,减少出血事件,安全性更高。更多还原

【Abstract】 Objective To discuss the clinical effect of dabigatran etexilate combined with ticagrelor in the treatment of elderly patients with atrial fibrillation and unstable angina pectoris and its influence on coagulation function. Methods A total of 120 elderly patients with atrial fibrillation and unstable angina pectoris were divided into observation group and control group according to admission order, with 60 cases in each group. The control group was treated with warfarin and ticagrelor on the basis of conventional treatment, while the observation group was treated with dabigatran etexilate combined with ticagrelor on the basis of conventional treatment. The coagulation indexes [prothrombin time(PT), thrombin time(TT), activated partial thromboplastin time(APTT)] before and after treatment, bleeding and occurrence of adverse cardiovascular events were compared between the two groups. Results After 3 and 12 months of treatment, the PT, TT and APTT of the two groups were longer than those before treatment. The PT, TT and APTT after 3 months of treatment of the observation group were(12.65±0.76),(14.24±3.11) and(32.25±4.55) s, which were longer than(11.56±1.85),(12.66±3.15) and(30.42±4.12) s of the control group, and the PT, TT and APTT after 12 months of treatment of the observation group were(13.62±1.32),(16.65±5.12) and(33.76±5.12) s, which were longer than(12.55±2.02),(14.23±7.26) and(31.12±5.87) s of the control group. The difference was statistically significant(P<0.05). The total bleeding rate 3.33% of the observation group was lower than 18.33% of the control group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in incidence of adverse cardiovascular events between the two groups(χ2=0, P>0.05). Conclusion Dabigatran etexilate combined with ticagrelor shows ideal effect in the treatment of elderly patients with atrial fibrillation and unstable angina pectoris, which can prevent thrombosis and reduce bleeding events with high safety.更多还原