广州医药2024，Vol.55Issue(2)：151-156,6.DOI:10.3969/j.issn.1000-8535.2024.02.009
利伐沙班对心力衰竭合并心房颤动患者凝血因子及预后情况的效果观察
Effect of rivaroxaban on coagulation factors and prognosis in patients with heart failure and atrial fibrillation
摘要
Abstract
Objective To observe the effect of rivaroxaban on coagulation factors and prognosis in patients of heart failure(HF)with atrial fibrillation(AF).Methods This is a prospective study.The patients were included from January 2021 to April 2022 in Pingdingshan Second People's Hospital.The study subjects were 123 patients with HF and AF.The enrolled patients were divided into the conventional group(61 cases)and the experimental group(62 cases)by the method of digital random table.Both groups were treated with cardiac resynchronization therapy with defibrillator(CRTD).The conventional group was treated with conventional anticoagulation therapy to assist CRTD,and the experimental group was treated with rivaroxaban to assist CRTD.All patients were followed up for one year after surgery,the changes in anti-Xa coagulation factors,myocardial injury markers,cardiac function indicators,as well as the incidence of postoperative thromboembolism and cardiovascular death events between the two groups of patients before and after treatment were compared.Results Before treatment,there were no statistically significant differences in Xa coagulation factor,myocardial injury markers and cardiac function indicators between the two groups of patients(P＞0.05).Under different anticoagulation regimens,the anti-Xa coagulation factor levels in the observation group were(130.44±20.18)IU/mg after 1 day of treatment,(115.36±20.77)IU/mg after 3 days of treatment,and(90.25±20.44)IU/mg after 7 days of treatment,which were lower than that in the conventional group[(145.33±20.19)IU/mg,(128.45±20.16)IU/mg,(103.34±20.17)IU/mg](P＜0.05).After treatment,the CK-MB level of the experimental group was(7.52±2.16)U/L,cTnI was(0.52±0.12)ng/mL,and LDH was(126.41±20.45)U/L,which were lower than that of the conventional group[(8.44±2.28)U/L,(0.94±0.31)ng/mL,(140.33±20.25)U/L](P＜0.05).After treatment,the left ventricular ejection fraction of the observation group was(56.12±10.41)%,which was higher than the conventional group(50.24±10.33)%,left ventricular diameter was(47.11±10.25)mm,left ventricular end disastolic volume was(36.72±10.43)mL,which were lower than the conventional group(53.28±10.14)mm,(42.77±10.36)mL(P＜0.05).During the follow-up period,the incidence of thromboembolism events in the experimental group was 4.84%(3/62),and the incidence of cardiovascular death events was 3.23%(2/62),which was lower than the conventional group[19.67%(12/61),14.75%(9/61)](P＜0.05).Conclusions Rivaroxaban assisted CRTD can effectively enhance the activity of anti-Xa coagulation factors in patients with HF and AF,which has positive significance in reducing myocardial injury,improving cardiac function and reducing the risk of thromboembolism or cardiovascular death.关键词
心力衰竭/心房颤动/起搏器植入术/凝血因子/心肌损伤/预后情况Key words
heart failure/atrial fibrillation/cardiac resynchronization therapy with defibrillator/coagulation factors/myocardial injury/prognostic situation引用本文复制引用
姚慧慧,蒋建青..利伐沙班对心力衰竭合并心房颤动患者凝血因子及预后情况的效果观察[J].广州医药,2024,55(2):151-156,6.基金项目
河南省医学科技攻关项目(LHGJ2020021837) （LHGJ2020021837）
