利伐沙班在冠心病合并心房颤动患者经皮冠状动脉介入术后抗栓治疗中的作用

目的探讨利伐沙班在冠心病合并心房颤动患者PCI术后抗栓治疗中的疗效及安全性。方法选取我院2016年08月~2018年08月收治的冠心病合并房颤并行经皮冠状动脉介入(PCI)术患者104例,随机分为试验组和对照组,每组各52例。术后两组均给予三联抗栓药物治疗6个月,之后双联抗栓药物治疗至12个月,其中试验组给予利伐沙班治疗,对照组给予华法林治疗。比较两组患者PCI前后凝血功能,同时观察血栓栓塞事件和出血事件发生情况。结果治疗后与治疗前比较,两组活化部分凝血活酶时间(aPTT)、凝血酶原时间(PT)均明显升高,差异有统计学意义(P<0.05),与试验组比较,对照组aPTT、PT升高更显著(P<0.05)。两组血栓栓塞事件发生率比较差异无统计学意义(P>0.05);两组出血事件发生率比较,试验组较对照组明显降低,差异有统计学意义(P<0.05)。结论利伐沙班在冠心病合并心房颤动患者PCI术后抗栓治疗中的疗效与华法林相当,而出血发生率低,安全性较高。

Effect of Rivaroxaban on Antithrombotic Therapy after PCI in Patients with Coronary Heart Disease Complicated with Atrial Fibrillation

Objective To investigate the effect and safety of rivaroxaban in antithrombotic therapy after PCI in coronary heart disease patients combining with atrial fibrillation.Methods 104 patients with coronary heart disease complicate with atrial fibrillation who underwent PCI surgery from August 2016 to August 2018 were randomly divided into experimental group and control group,52 cases in each group.Both groups were given triple antithrombotic therapy for 6 months,followed by double antithrombotic therapy for 12 months.The experimental group was given rivaroxaban treatment,while the control group was given warfarin treatment.Compare two groups before and after treatment in patients with coagulation index changes and the incidence of postoperative cardiovascular events and hemorrhage.Results After treatment and before treatment,the activated partial thromboplastin time(aPTT)and prothrombin time(PT)of the two groups were significantly increased,and the difference was statistically significant(P<0.05).Compared with the experimental group,the increase of aPTT and PT in the control group was more significant(P<0.05).There was no statistically significant difference in the incidence of cardiovascular and cerebrovascular events between the two groups(P>0.05),while the incidence of total bleeding events in the test group was significantly lower than that in the control group(P<0.05).Conclusion The efficacy of rivaroxaban inantithrombotic therapy after PCI in patients with coronary heart disease combined with atrial fibrillation is comparable to warfarin,but the incidence of bleeding is low and the safety is high.