摘要
目的探讨达比加群酯对急性缺血性脑卒中并发心房颤动(AF)患者治疗的有效性及安全性。方法选取本院2018年3月至2020年5月收治的104例急性缺血性脑卒中并发AF患者,按照随机数字表法划分成A、B组,每组52例。2组入院后均给予神经内科常规治疗,在此基础上A应用华法林治疗,B组应用达比加群酯治疗。于治疗前、治疗3个月后测定2组凝血功能指标活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、D-二聚体(D-D)、采用美国国立卫生研究院卒中量表(NIHSS)评定2组神经功能缺损情况,并统计2组治疗3个月内血栓栓塞及不良反应发生率。结果治疗3个月后,2组APTT、PT与治疗前相比均升高(P<0.05),且APTT、PT水平B组明显较A组高(P<0.05);2组D-D水平及NIHSS评分与治疗前相比均降低(P<0.05),且B组均明显较A组低(P<0.05);2组血栓栓塞发生率比较差异无统计学意义(P>0.05),B组出血事件发生率明显低于A组(P<0.05)。结论对急性缺血性脑卒中并发AF患者应用达比加群酯治疗,可有效延长APTT、PT,降低D-D,且显著减轻神经功能损伤,降低血栓栓塞发生率,且出血风险低,用药安全性高。
Objective To investigate the efficacy and safety of dabigatran etexilate on coagulation function in acute ischemic stroke(AIS)patients combined with new-onset atrial fibrillation(AF).Methods From March 2018 to May 2020,104 AIS patients combined with new-onset AF in our hospital were randomly divided into group A and group B,with 52 cases in each group.After admission,patients in both groups were given a routine treatment in the neurology department,and those in group A and group B were additionally treated with warfarin and dabigatran etexilate,respectively.The coagulation function indexes,including the activated partial thromboplastin time(APTT),prothrombin time(PT),and D-Dimer(D-D)before treatment and after 3 months of treatment were recorded.National Institutes of Health Stroke Scale(NIHSS)was used to evaluate the neurological deficit.The incidence of thromboembolism and adverse events within 3 months of treatment in the two groups was recorded.Results After 3 months of treatment,APTT and PT in both groups were significantly enhanced than those before treatment(P<0.05),which were significantly higher in group B than those in group A(P<0.05).D-D level and NIHSS scores in both groups were significantly reduced than those before treatment(P<0.05),which were significantly lower in group B than those in group A(P<0.05).There was no significant difference in the incidence of thromboembolism between the two groups(P>0.05),while the incidence of bleeding events in group B was significantly lower than that in group A(1.92%vs 15.38%,P<0.05).Conclusion For AIS patients combined with new-onset AF,dabigatran etexilate effectively prolongs APTT and PT,protects nerve function,and reduces D-D and the incidence of thromboembolism.The treatment of dabigatran etexilate is safe,with a low risk of bleeding.
作者
齐秀彦
蔺辉前
侯永革
苏晓辉
郜艳芳
QI Xiuyan;LIN Huiqian;HOU Yongge(Department of Neurology,Shijiazhuang People’s Hospital,Hebei,Shijiazhuang 050000,China)
出处
《河北医药》
CAS
2023年第11期1713-1715,共3页
Hebei Medical Journal
基金
河北省医学科学研究重点课题计划项目(编号:20191480)。
关键词
达比加群酯
缺血性脑卒中
心房颤动
凝血功能
dabigatran etexilate
acute ischemic stroke
atrial fibrillation
coagulation function
