【摘要】 目的：探析高龄非瓣膜性房颤伴不稳定型心绞痛患者采用达比加群酯联合氯吡格雷治疗的效果。方法：选取2019年1月-2022年1月北华大学附属医院收治的100例高龄非瓣膜性房颤伴不稳定型心绞痛患者作为研究对象，随机分为对照组和观察组，各50例。对照组采用华法林联合氯吡格雷进行治疗，观察组采用氯吡格雷联合达比加群酯进行治疗。对比两组用药前后血液流变学、凝血功能指标及不良反应发生率。结果：用药前，两组血浆比黏度、纤维蛋白原、全血比黏度(高切与低切)水平比较，差异无统计学意义(P>0.05)；用药后，两组血浆比黏度、纤维蛋白原、全血比黏度(高切与低切)水平均低于用药前，且观察组均低于对照组，差异有统计学意义(P<0.05)。用药前，两组D-二聚体、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、国际标准化比值(INR)、凝血酶原时间(PT)水平比较，差异无统计学意义(P>0.05)；用药后，两组D-二聚体、TT、APTT、INR、PT水平均高于用药前，且观察组均高于对照组，差异有统计学意义(P<0.05)。观察组血管栓塞事件、再出血发生率均低于对照组，差异有统计学意义(P<0.05)。结论：高龄非瓣膜性房颤伴不稳定型心绞痛患者采用达比加群酯配合氯吡格雷治疗的效果显著，值得临床应用并予以推广。更多还原

【Abstract】 Objective:To explore the effect of dabigatran etexilate combined with clopidogrel in the treatment of elderly patients with non-valvular atrial fibrillation complicated with unstable angina pectoris.Methods:A total of 100 elderly patients with nonvalvular atrial fibrillation complicated with unstable angina pectoris who were treated in Affiliated Hospital of Beihua University from January 2019 to January 2022 were selected as the study subjects.They were randomly divided into control group and observation group,with 50 cases in each group.The control group was treated with warfarin and clopidogrel and the observation group was treated with clopidogrel and dabigatran etexilate.The hemorheology,blood coagulation function index and incidence of adverse reactions were compared between the two groups before and after drug treatment.Results:Before medication,there were no statistically significant differences in the levels of plasma specific viscosity,fibrinogen and whole blood specific viscosity(high shear and low shear) between the two groups(P>0.05).After medication,the levels of plasma specific viscosity,fibrinogen and whole blood specific viscosity(high shear and low shear) in the two groups were lower than those before medication,and the observation group was lower than the control group,and the difference was statistically significant(P<0.05).Before medication,there were no statistically significant differences in the levels of D-dimer,thrombin time(TT),activated partial thromboplastin time(APTT),international normalized ratio(INR),and prothrombin time(PT) between the two groups(P>0.05).After medication,the levels of Ddimer,TT,APTT,INR and PT in the two groups were higher than those before medication,and the observation group was higher than the control group,and the difference was statistically significant(P<0.05).The incidence of vascular embolism event and rebleeding in the observation group was lower than that in the control group,and the differences were statistically significant(P<0.05).Conclusion:The treatment of dabigatran etexilate combined with clopidogrel achieves significant effect in elderly patients with nonvalvular atrial fibrillation complicated with unstable angina pectoris,and deserves clinical application and promotion.更多还原