[1]胡忠慧,姜云生,王肃.利伐沙班用于持续性心房颤动合并2型糖尿病高龄患者抗凝治疗安全性的研究[J].国际内分泌代谢杂志,2021,41(04):327-331.[doi:10.3760/cma.j.cn121383-20210102-01002]
　Hu Zhonghui,Jiang Yunsheng,Wang Su..Clinical study on the safety of rivaroxaban in elderly patients with persistent atrial fibrillation and type 2 diabetes mellitus[J].International Journal of Endocrinology and Metabolism,2021,41(04):327-331.[doi:10.3760/cma.j.cn121383-20210102-01002]
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利伐沙班用于持续性心房颤动合并2型糖尿病高龄患者抗凝治疗安全性的研究()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
41
期数:
2021年04期
页码:
327-331
栏目:
论著
出版日期:
2021-07-20

文章信息/Info

Title:
Clinical study on the safety of rivaroxaban in elderly patients with persistent atrial fibrillation and type 2 diabetes mellitus
作者:
胡忠慧; 姜云生; 王肃
天津市第五中心医院内分泌科 300450
Author(s):
Hu Zhonghui;  Jiang Yunsheng;  Wang Su.
Department of Endocrinology, the Fifth Central Hospital of Tianjin, Tianjin 300450, China
关键词:
利伐沙班;  持续性心房颤动;  抗凝治疗;  高龄;  2型糖尿病
Keywords:
Rivaroxaban;  Persistent atrial fibrillation;  Anticoagulation therapy;  Elderly patients;  Type 2 diabetes mellitus
DOI:
10.3760/cma.j.cn121383-20210102-01002
摘要:
目的 观察新型口服抗凝药利伐沙班用于高龄(>80岁)患者持续性心房颤动(PerAF)合并2型糖尿病抗凝治疗的安全性和有效性。方法 选取2014年9月至2018年12月于天津市第五中心医院门诊就诊的高龄PerAF合并2型糖尿病患者共141例,118例患者完成随访,入选本研究,患者随机分为利伐沙班组(A组,n=59)和对照组(口服华法林,B组,n=59),收集两组患者的基线资料,进行CHA2DS2-VASc、HAS-BLED评分,随访1年,监测国际标准化比值(INR)水平,比较两组患者出血、栓塞事件的发生率。结果 两组患者基线临床资料中性别、年龄、CHA2DS2-VASc评分、HAS-BLED评分、体重指数、血钾、估算的肾小球滤过率、尿酸、糖化血红蛋白A1c(HbA1c)、超声心动图参数差异无统计学意义(P均>0.05); 两组患者糖尿病病史差异有统计学意义(P=0.016)。随访1年,两组牙龈出血、皮肤瘀斑、咳血、呕血、黑便、尿血、脑出血、脑栓塞、周围动脉栓塞的发生率无差别(P均>0.05)。A组出血总发生率20.3%,B组出血总发生率33.9%,其中B组发生1例致命性脑出血,两组患者总体出血的发生率差别无统计学意义(P=0.098)。两组患者均无血栓栓塞事件发生。结论 利伐沙班可用于高龄患者PerAF合并2型糖尿病抗凝治疗,与华法林安全性相似。
Abstract:
Objective To observe the efficacy and safety of the novel oral anticoagulant rivaroxaban for anticoagulation therapy in elderly patients(>80 years old)with persistent atrial fibrillation(PerAF)and type 2 diabetes mellitus.Methods From September 2014 to December 2018, 141 elderly patients with PerAF and type 2 diabetes were recruited from Tianjin Fifth Central Hospital. 118 patients completed the follow-up were included in this study and were randomly divided into two groups: rivaroxaban group(Group A, n=59)and warfarin group(Group B, n=59). The baseline data were collected, the CHA2DS2-VASc and HAS-BLED scores were calculated, the INR level was monitored, and the incidence of bleeding and embolism events were statistically compared.Results There were no significant differences between the two groups in the baseline clinical data of gender, age, CHA2DS2-VASc score, HAS-BLED score, body mass index, blood potassium, estimated glomerular filtration rate, uric acid, glycosylated hemoglobin(HbA1c)and echocardiographic parameters(all P>0.05). The difference between the two groups in the history of diabetes was statistically significant(P=0.016). During one year follow-up, the incidences of gingival bleeding, skin ecchymosis, hemoptysis, haematemesis, black stool, uremia, cerebral hemorrhage, cerebral embolism and peripheral arterial embolism were similar between the two groups. The whole incidence of hemorrhage in group A was 20.3%, and that in group B was 33.9%, without significant difference between the two groups(P=0.098). One case of fatal cerebral hemorrhage occurred in group B. There was no thromboembolism in both groups.Conclusion Rivaroxaban can be used for anticoagulation therapy in elderly patients with PerAF and type 2 diabetes mellitus,the safety is similar to Warfarin.

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备注/Memo

备注/Memo:
通信作者:王肃,Email: wsrealm@126.com
更新日期/Last Update: 1900-01-01