摘要
目的研究利伐沙班联合氯吡格雷对心房颤动(房颤)合并冠心病行经皮冠状动脉介入治疗(PCI)术患者的疗效和安全性。方法82例房颤合并冠心病行PCI术患者,根据随机数字表法分为对照组和研究组,每组41例。对照组患者术后给予华法林钠+氯吡格雷治疗,研究组患者术后给予利伐沙班+氯吡格雷治疗。比较两组出血性事件发生情况、治疗前后心功能指标及不良心脑血管事件发生情况。结果两组患者心肌梗死的溶栓治疗(TIMI)、全球梗死相关动脉开通策略(GUSTO)出血分级中大出血发生率比较差异无统计学意义(P>0.05);研究组TIMI、GUSTO出血分级中小出血、轻微出血发生率均低于对照组,差异具有统计学意义(P<0.05)。治疗后,研究组左室舒张末期内径(LVEDD)(46.36±3.69)mm、左心室射血分数(LVEF)(56.64±1.87)%、二尖瓣口舒张早期最大流速与舒张末期最大流速比率(E/A)(1.56±0.03)均优于对照组的(51.55±6.52)mm、(51.23±2.65)%、(1.11±0.03),差异具有统计学意义(P<0.05)。研究组患者的不良心脑血管事件发生率7.32%低于对照组的24.39%,差异具有统计学意义(P<0.05)。结论对于房颤合并冠心病行PCI术的患者,术后选择利伐沙班联合氯吡格雷治疗,可改善患者心功能,并降低出血事件发生率,治疗期间安全性较高,值得应用。
Objective To study the efficacy and safety of rivaroxaban combined with clopidogrel in patients with atrial fibrillation and coronary heart disease undergoing percutaneous coronary intervention(PCI).Methods A total of 82 patients with atrial fibrillation and coronary heart disease undergoing PCI were divided into the control group and the research group according to random numerical table,with 41 cases in each group.Patients in the control group were treated with warfarin sodium and clopidogrel postoperatively,and patients in the research group were treated with rivaroxaban and clopidogrel postoperatively.The occurrence of hemorrhagic events,cardiac function indexes before and after treatment,and occurrence of adverse cardiovascular and cerebrovascular events were compared between the two groups.Results There was no statistically significant difference in the incidence of major hemorrhage in thrombolysis in myocardial infarction(TIMI)and the global utilization of streptokinase and t-PA for occluded coronary arteries(GUSTO)bleeding classification between the two groups(P>0.05).After treatment,the left ventricular end diastolic diameter(LVEDD)(46.36±3.69)mm,left ventricular ejection fraction(LVEF)(56.64±1.87)%,early diastolic peak flow velocity of mitral valve/late diastolic peak flow velocity of mitral valve(E/A)(1.56±0.03)of the research group were better than(51.55±6.52)mm,(51.23±2.65)%,(1.11±0.03)of the control group,and the difference was statistically significant(P<0.05).The incidence of adverse cardiovascular and cerebrovascular events 7.32%in the research group was lower than 24.39%in the control group,and the difference was statistically significant(P<0.05).Conclusion In patients who underwent PCI for atrial fibrillation combined with coronary artery disease,postoperative treatment with rivaroxaban and clopidogrel can improve the cardiac function and reduce the incidence of bleeding events in patients with a high safety profile during treatment,which is worth applying.
作者
那美晶
NA Mei-jing(Department One of Cardiology,Zhuanghe Central Hospital,Zhuanghe 116400,China)
出处
《中国实用医药》
2022年第3期4-7,共4页
China Practical Medicine
关键词
利伐沙班
氯吡格雷
心房颤动
冠心病
经皮冠状动脉介入治疗
Rivaroxaban
Clopidogrel
Atrial fibrillation
Coronary heart disease
Percutaneous coronary intervention
