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华法林、利伐沙班和达比加群酯在老年心房颤动患者中的应用价值及安全性分析。

Application Value and Safety Analysis of Warfarin, Rivaroxaban, and Dabigatran Ester in Elderly Patients With Atrial Fibrillation.

机构信息

Department of Geriatrics, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Huangshi, Hubei, China.

Department of General Practice, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Huangshi, Hubei, China.

出版信息

Clin Cardiol. 2024 Sep;47(9):e70014. doi: 10.1002/clc.70014.

Abstract

BACKGROUND

This study aimed to evaluate the application value and safety of Warfarin, Rivaroxaban, and Dabigatran in elderly patients with atrial fibrillation.

METHODS

A total of 180 elderly patients with atrial fibrillation admitted to our hospital were retrospectively analyzed. According to their anticoagulant treatment regimen, patients were divided into three groups: Warfarin (57 cases), Rivaroxaban (61 cases), and Dabigatran (62 cases). General demographic information was collected, and coagulation function indicators-including fibrinogen (FIB), thrombin time (PT), activated partial thrombin time (APTT), and D-dimer (D-D)-as well as liver function indexes-including total bilirubin (TbiL), alkaline phosphatase (ALP), aspartate aminotransferase (AST), and alanine transferase (ALT)-were compared before and after 4 weeks of treatment.

RESULTS

There were no significant differences in demographic characteristics such as gender, age, body mass index, or disease course among the three groups. The total effective rate in the Warfarin group (84.21%) was significantly lower than in the Rivaroxaban (98.36%) and Dabigatran (96.77%) groups (p < 0.05). However, there was no significant difference in the total effective rate between the Rivaroxaban and Dabigatran groups (p > 0.05). Additionally, no significant differences were found in the effects of the three drugs on coagulation function, liver function, or the incidence of bleeding (p = 0.052).

CONCLUSION

Warfarin, Rivaroxaban, and Dabigatran can effectively prevent thrombosis in elderly patients with atrial fibrillation, with Rivaroxaban and Dabigatran showing superior effectiveness. All three drugs demonstrated similar low rates of bleeding events and had no significant impact on coagulation and liver function.

摘要

背景

本研究旨在评估华法林、利伐沙班和达比加群在老年房颤患者中的应用价值和安全性。

方法

回顾性分析我院收治的 180 例老年房颤患者,根据抗凝治疗方案将患者分为三组:华法林组(57 例)、利伐沙班组(61 例)和达比加群组(62 例)。收集一般人口学信息,比较治疗前及治疗 4 周后凝血功能指标[纤维蛋白原(FIB)、凝血酶时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体(D-D)]及肝功能指标[总胆红素(TbiL)、碱性磷酸酶(ALP)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)]。

结果

三组患者性别、年龄、体质量指数、病程等一般资料比较,差异无统计学意义。华法林组总有效率(84.21%)显著低于利伐沙班组(98.36%)和达比加群组(96.77%)(p<0.05)。但利伐沙班组和达比加群组总有效率比较,差异无统计学意义(p>0.05)。此外,三组药物对凝血功能、肝功能及出血发生率的影响比较,差异均无统计学意义(p=0.052)。

结论

华法林、利伐沙班和达比加群均可有效预防老年房颤患者血栓形成,利伐沙班和达比加群效果更优。三组药物出血事件发生率均较低,且对凝血及肝功能均无明显影响。

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