作　　者： (黄家贵）; (何艳）; (刘骅）; (唐义平）;

机构地区： 四川省宜宾市第二人民医院神经内科,四川宜宾644000

出　　处： 《实用医院临床杂志》 2017年第5期139-141,共3页

摘　　要： 目的探讨高龄卒中伴心房颤动(房颤)患者使用低剂量达比加群酯的临床疗效及安全性。方法对400例脑卒中伴房颤患者进行房颤血栓栓塞危险评分以及抗凝出血风险评分,检测其肾小球滤过率以及血液肌酐水平;将190例接受抗凝治疗的高龄卒中伴房颤患者分为达比加群酯组和华法林组,分析两组的血栓栓塞和出血事件。结果与低龄组比较,高龄组患者发生血栓栓塞事件风险高,肾脏代谢能力下降,接受抗凝治疗时出血风险大;达比加群酯组与华法林组比较,血栓栓塞发生率差异无统计学意义(P>0.05),但出血发生率较低(P<0.05)。结论高龄卒中伴房颤患者使用低剂量达比加群酯抗凝对预防血栓栓塞事件有效。 Objective To observe the clinical efficacy stroke patients with atrial fibrillation. Methods Four hundred and safety of low dose dabigatran etexilate in the treatment of elderly stroke patients with atrial fibrillation were scored by atrial fibrillation thromboembolism risk score and anticoagulation bleeding risk score. The glomerular filtration rate and the blood creatinine levels were also detected. Of these patients, 190 cases with atrial fibrillation who underwent anticoagulation treatment were randomly assigned into 2 groups ： dabigatran etexilate group and warfarin group. Main outcome measures including the incidence rates of bleeding and thromboem- bolic events were analyzed. Results Compared with young group, elderly stroke patients with atrial fibrillation had the high risk of thromboembolic events and bleeding events during anticoagulant therapy, and a reduced kidney metabolism. There was no statistically significant difference in the rate of thromboembolic events between the dabigatran etexilate group and the warfarin group （P 〉 0. 05 ）. In contrast, the dabigatran etexilate group had a lower incidence of bleeding events than the warfarin group （P 〈 0. 05）. Conclusion It is effective for elderly stroke patients with atrial fibrillation to use low dose of dabigatran etexilate for preventing thromboembolic events.

关 键 词： 达比加群酯 心房颤动 高龄卒