摘要
目的探讨非瓣膜性心房颤动(房颤)患者应用新型口服抗凝药(new oral anticoagulants,NOACs)的依从性及其主要影响因素。方法连续入选2018年1月1日至2018年12月31日于徐州医科大学附属医院心内科住院并行保守抗凝治疗的非瓣膜性房颤性患者272例,根据应用抗凝药种类不同分为华法林组96例和新型口服抗凝药组176例,出院后进行电话随访,比较两组患者抗凝依从性和各自停药原因及影响因素。结果华法林组与NOACs组患者在性别分布、心功能分级、合并疾病方面无统计学差异。平均随访(8.80±3.51)月,NOACs组停药率显著高于华法林组(57.39%vs.22.92%,P<0.001)。对房颤疾病本身及其危害认识不足是两组患者停药的共同主要原因,经济因素、购买因素、出血因素、对疾病缺乏认识对两组患者停用抗凝药均具有显著影响。结论目前新型口服抗凝药服药依从性仍较低,多种因素影响房颤抗凝,其中对房颤缺乏正确认识是导致患者停药的主要原因。
Objective To investigate the compliance of new oral anticoagulants(NOACs)and its main influencing factors in patients with nonvalvular atrial fibrillation.Methods 272 consecutive patients with nonvalvular atrial fibrillation who were hospitalized with conservative anticoagulation in the Department of Cardiology of the Affiliated Hospital of Xuzhou Medical University from January 1,2018 to December 31,2018 were selected.96 patients in the warfarin group and 176 patients in the new oral anticoagulant group were followed up by telephone after discharge.The two groups were compared for anticoagulant compliance and their reasons for discontinuation and the influencing factors.Results There were no statistical differences between the warfarin group and the NOACs group in terms of gender distribution,cardiac function classification,and comorbidities.The mean followup(8.80±3.51)months,the withdrawal rate of NOACs group was significantly higher than that of warfarin group(57.39%vs.22.92%,P<0.001).Insufficient understanding of AF disease itself and its harms are the common reasons for discontinuation of medication in two groups of patients.Economic factors,purchase factors,bleeding factors,and lack of awareness of the disease have a significant impact on the discontinuation of anticoagulants in both groups.Conclusion At present,the compliance of new oral anticoagulants is still low.Many factors affect the anticoagulation of atrial fibrillation.Among them,the lack of correct understanding of atrial fibrillation is the main reason for discontinuation of patients.
作者
高贝贝
李承宗
李菲
韦慧
陈文苏
徐长江
张超群
王志荣
Gao Beibei;Li Chengzong;Li Fei;Wei Hui;Chen Wensu;Xu Changjiang;Zhang Chaoqun;Wang Zhirong(Department of Cardiology,Affiliated Hospital of Xuzhou Medical University,Xuzhou,221000,China)
出处
《中国循证心血管医学杂志》
2020年第2期188-191,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
农业社发计划项目(KC19158)。
关键词
心房颤动
抗凝治疗
新型口服抗凝药
依从性
Atrial fibrillation
Anticoagulant therapy
New oral anticoagulant
Compliance
