摘要
目的 评估达比加群酯用于心房颤动（房颤）导管消融术后抗凝治疗的有效性及安全性.方法 自2013年3月11日至2014年4月16日在沈阳军区总医院将接受房颤射频导管消融的患者分为达比加群酯组60例和华法林组60例.达比加群酯组：房颤导管消融术后给予110 mg或150mg,每日2次口服,至少服用2个月.华法林组：房颤导管消融术后给予3～6 mg,根据国际标准化比值（INR）调整剂量,控制INR在2.0～3.0,至少服用2个月.所有患者从抗凝开始到抗凝结束选用同一种抗凝药物.结果 ①基线水平比较,除收缩压外其他指标差异均无统计学意义（P＞0.05）;②两组有效性及安全性比较：华法林组和达比加群酯组均无血栓栓塞事件及大出血事件发生;华法林组和达比加群酯组不明显出血事件分别为4例和2例（P＞0.05）.华法林组及达比加群酯组的平均总住院时间分别为[（15.1±6.7）d对（10.2±3.3）d,P＜0.05],平均术后住院时间分别为[（6.2±4.3）d对（2.8±1.6）d,P＜0.05],华法林组的总住院天数及术后住院天数较达比加群酯组明显延长.结论 口服达比加群酯用于血栓栓塞低、中危房颤患者导管消融术后抗凝安全有效,且可明显降低住院天数.
Objective To evaluate the effectiveness and safety of anticoagulant therapy with dabigatran etexilate in patient after radiofrequency catheter ablation（RFCA） of atrial fibrillation（AF）.Methods A cohort of 120 patients who underwent RFCA of AF was enrolled.The 120 patients were divided into dabigatran group （60 patients） and warfarin Group （60 patients）.In dabigatran etexilate group,dabigatran etexilate （110 mg or 150 mg,bid）was given for at least 2 month.In warfarin group,standard medication of warfarin was given for at least 2 months by adjusting the INR in the range between 2.0 and 3.0.All the patients took the same anticoagulant during the whole period of anticoagulation therapy.Results ①There were no significant differences in baseline characteristics between two groups except the systolic blood pressure.②There were no significant differences between 2 groups in the death and thromboembolism events,including cerebral,systemic and pulmonary emboli（none in both groups）.There were no TIMI major bleeding events in both groups.There were no significant differences in minor bleeding events between two groups （2/60 vs 4/60） （P＞ 0.05）.The length of hospital stay （including both total and post-ablation hospital stay）was significantly shorter in dabigatran etexilate group than in warfarin group.Conclusion Compared with oral warfarin,the effectiveness and safety of oral dabigatran etexilate had similar effect in the patients after RFCA of AF.Dabigatran etexilate could be safely and effectively used in AF patients with low or middle risk of thromboembolism after RFCA,and could significantly decrease the length of hospital stay.
出处
《中华心律失常学杂志》
2015年第2期99-103,共5页
Chinese Journal of Cardiac Arrhythmias
基金
辽宁省第四批科学技术计划资助（2014305006）,辽宁省自然科学基金（20102247）
关键词
心房颤动
导管消融术
抗凝治疗
华法林
达比加群酯
Atrial fibrillation
Radiofrequency catheter ablation
Oral anticoagulant
Warfarin
Dabigatran etexilate
