【摘要】：目的： 通過回顧分析研究達比加群酯與華法林對心房顫動射頻消融患者抗凝治療中的臨床療效。 方法： 研究對象選自2012年1月-2015年1月吉林大學第一附屬醫(yī)院心內(nèi)科收治行導管射頻消融治療的房顫患者107例。收集所有患者的年齡、性別、肝功、腎功等基本指標。所有患者均經(jīng)過納入排除標準篩選，，于圍手術(shù)期應(yīng)用華法林亦或是達比加群酯行抗凝治療。對患者進行1年隨訪，以血栓性終點與安全性終點為研究終點，對比兩組患者的臨床療效和出血風險。 結(jié)果: 1、達比加群酯觀察組血栓栓塞事件的發(fā)生率為3.2%(1/31)，華法林對照組血栓栓塞事件的發(fā)生率為3.9%(3/76)，兩組差異不拘有統(tǒng)計學意義(P＞0.05）。華法林導致缺血性腦卒中病例的INR未達標。 2、達比加群酯觀察組出血并發(fā)癥的發(fā)生率為6.5%(2/31)，華法林對照組出血并發(fā)癥的發(fā)生率為9.2%(5/76)；兩組差異不具有統(tǒng)計學意義(P＞0.05）。兩組均未見嚴重出血并發(fā)癥。 結(jié)論： 1、心房顫動射頻消融采用達比加群酯抗凝治療療效確切，不劣于華法林抗凝治療。 2、心房顫動射頻消融采用達比加群酯抗凝治療與華法林抗凝治療的出血風險相當，免于INR檢測。
[Abstract]:Objective: to study the clinical effect of radiofrequency ablation of atrial fibrillation (AF) with dabiganate and warfarin. Methods: 107 patients with atrial fibrillation treated by radiofrequency catheter ablation were selected from January 2012 to January 2015 in Cardiology Department of the first affiliated Hospital of Jilin University. The age, sex, liver function and kidney function of all patients were collected. All patients were screened by exclusion criteria for anticoagulant therapy with warfarin or dacitrate during perioperative period. The patients were followed up for 1 year. Thrombotic endpoints and safety endpoints were used as the study endpoints to compare the clinical efficacy and bleeding risk between the two groups. Results: 1. The incidence of thromboembolism was 3.2% (1 / 31) in the Darby plus group and 3.9% (3 / 76) in the warfarin control group. The difference between the two groups was statistically significant (P > 0.05). Warfarin leads to INR substandard in ischemic stroke cases. 2. The incidence of bleeding complications in the observation group was 6.5% (2 / 31), and that in the warfarin control group was 9.2% (5 / 76), there was no significant difference between the two groups (P > 0.05). No severe bleeding complications were found in both groups. Conclusion: 1. Radiofrequency catheter ablation of atrial fibrillation is effective in treating atrial fibrillation with dapib plus group ester, and is not inferior to warfarin anticoagulant therapy. 2, radiofrequency ablation of atrial fibrillation with dapib plus group ester anticoagulant therapy had the same risk of bleeding as warfarin anticoagulant therapy, and was exempt from INR detection.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R541.75

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