摘要
目的对比达比加群、华法林在急性心肌梗死合并左心室血栓(LVT)中的临床疗效。方法收集2015年9月—2020年3月辽宁省人民医院住院且诊断为急性心肌梗死合并左心室血栓的116例患者为研究对象,随机分为华法林组和达比加群组,观察各组患者卒中发生率、出血事件发生率、治疗前和治疗后3个月凝血功能指标、治疗前和治疗后1个月及3个月肝功能指标,并比较两组患者血栓消失时间、治疗期间新发血栓栓塞事件以及出血事件。结果治疗期间,达比加群组较华法林组总栓塞事件发生率较少(3.4%比24.1%,P=0.002),其中脑栓塞(1.7%比15.5%,P=0.016)差异具有统计学意义(P<0.05);两组患者凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)比较差异无统计学意义(P>0.05),达比加群组活化部分凝血活酶时间(APTT)高于华法林组,两组间比较差异有显著性(P<0.05);两组患者治疗后1个月及3个月肝功能指标比较差异无统计学意义(P>0.05);与华法林组比较,达比加群组血栓消失时间更短[(47.00±5.30)天比(69.10±7.90)天,P<0.01],两组左心室血栓消失率相比,达比加群组明显多于华法林组(77.6%比39.7%,P=0.032);出血事件发生率达比加群组显著低于华法林组(3.4%比17.2%,P<0.05)。结论对急性心肌梗死合并左心室血栓的患者,达比加群治疗较华法林更为安全有效。
Aim To compare the clinical efficacy of dabigatran and warfarin in acute myocardial infarction with left ventricular thrombosis(LVT). Methods A total of 116 patients diagnosed with acute myocardial infarction and LVT who were hospitalized in Liaoning Provincial People’s Hospital from september 2015 to march 2020 were collected and randomly divided into warfarin group and dabigatran group. Stroke rate, bleeding event rate, coagulation function indexes before and after 3 months of treatment, liver function indexes before and 1 month and 3 months after treatment were observed, and the disappearance time of thrombosis, new thromboembolic events and bleeding events during treatment were compared between the two groups. Results During the treatment, the dabigatran group had fewer total embolization events than the warfarin group(3.4% vs 24.1%, P=0.002), of which cerebral embolism(1.7% vs 15.5%, P=0.016) was statistically significant(P<0.05);There was no statistically significant difference in prothrombin time(PT), thrombin time(TT) and fibrinogen(FIB) between the two groups(P>0.05), activated partial thromboplastin time(APTT) was higher in the dabigatran group than that in warfarin group(P<0.05). There was no statistically significant difference in liver function indexes of patients 1 month and 3 months after treatment between the two groups(P>0.05). Compared with the warfarin group, the patients in the dabigatran group had a shorter thrombus disappearance time((47.00±5.30) days vs(69.10±7.90) days, P<0.01). The number of cases of left ventricular thrombus disappearance in dabigata group was significantly more than that in warfarin group(77.6% vs 39.7%, P=0.032). The incidence of bleeding in dabigatran group was lower than that of warfarin group(3.4% vs 17.2%, P<0.05). Conclusion Dabigatran is safer and more effective than warfarin in the treatment of patients with acute myocardial infarction and left ventricular thrombosis.
作者
孙丹
张京京
王成福
徐嘉
SUN Dan;ZHANG Jingjing;WANG Chengfu;XU Jia(Cardiovascular Disease Treatment Center,Liaoning Provincial Peoples Hospital,Shenyang,Liaoning 110015,China)
出处
《中国动脉硬化杂志》
CAS
2021年第9期788-793,共6页
Chinese Journal of Arteriosclerosis
基金
辽宁省自然科学基金项目(20180550056)。
关键词
达比加群
华法林
急性心肌梗死
心力衰竭
左心室血栓
抗凝药
栓塞
dabigatran
warfarin
acute myocardial infarction
heart failure
left ventricular thrombosis
anticoagulant
embolism
