中国循环杂志
中國循環雜誌
중국순배잡지
CHINESE CIRCULATION JOURNAL
2015年
6期
559-561
,共3页
李秀芬%葛振嵘%帕尔哈提·吐尔逊
李秀芬%葛振嶸%帕爾哈提·吐爾遜
리수분%갈진영%파이합제·토이손
利伐沙班%华法林%左心室心尖部血栓%抗凝药
利伐沙班%華法林%左心室心尖部血栓%抗凝藥
리벌사반%화법림%좌심실심첨부혈전%항응약
Rivaroxaban%Warfarin%Left ventricular thrombus%Anticoagulant drug
目的：比较利伐沙班与华法林治疗左心室心尖部血栓的疗效及安全性。方法：31例左心室心尖部血栓患者随机分为两组，华法林组（n=16例）患者初始治疗与低分子肝素合用，剂量2.5~3 mg，至国际标准化比值（INR）达2.0~3.0停用低分子肝素，继续维持华法林治疗，3天监测1次INR，共3次， INR稳定在2.0~3.0，以后每2周监测1次INR；利伐沙班组（n=15例）患者口服利伐沙班片剂10 mg，2次/d。随访时间3个月，比较两组患者血栓消失时间、治疗期间新发血栓栓塞事件以及出血事件。结果：两组患者在年龄、性别、合并疾病、血栓大小及药物治疗等方面差异均无统计学意义。与华法林组比较，利伐沙班组的血栓消失时间缩短[（60.00±5.50）d vs （71.00±8.50）d，P<0.01]；两组的新发血栓栓塞事件（脑栓塞、体循环栓塞）差异无统计学意义（P>0.05），华法林组出血事件多于利伐沙班组，但差异也无统计学意义（P>0.05）。结论：治疗左心室心尖部血栓利伐沙班较华法林起效更快，不增加出血风险。
目的：比較利伐沙班與華法林治療左心室心尖部血栓的療效及安全性。方法：31例左心室心尖部血栓患者隨機分為兩組，華法林組（n=16例）患者初始治療與低分子肝素閤用，劑量2.5~3 mg，至國際標準化比值（INR）達2.0~3.0停用低分子肝素，繼續維持華法林治療，3天鑑測1次INR，共3次， INR穩定在2.0~3.0，以後每2週鑑測1次INR；利伐沙班組（n=15例）患者口服利伐沙班片劑10 mg，2次/d。隨訪時間3箇月，比較兩組患者血栓消失時間、治療期間新髮血栓栓塞事件以及齣血事件。結果：兩組患者在年齡、性彆、閤併疾病、血栓大小及藥物治療等方麵差異均無統計學意義。與華法林組比較，利伐沙班組的血栓消失時間縮短[（60.00±5.50）d vs （71.00±8.50）d，P<0.01]；兩組的新髮血栓栓塞事件（腦栓塞、體循環栓塞）差異無統計學意義（P>0.05），華法林組齣血事件多于利伐沙班組，但差異也無統計學意義（P>0.05）。結論：治療左心室心尖部血栓利伐沙班較華法林起效更快，不增加齣血風險。
목적：비교리벌사반여화법림치료좌심실심첨부혈전적료효급안전성。방법：31례좌심실심첨부혈전환자수궤분위량조，화법림조（n=16례）환자초시치료여저분자간소합용，제량2.5~3 mg，지국제표준화비치（INR）체2.0~3.0정용저분자간소，계속유지화법림치료，3천감측1차INR，공3차， INR은정재2.0~3.0，이후매2주감측1차INR；리벌사반조（n=15례）환자구복리벌사반편제10 mg，2차/d。수방시간3개월，비교량조환자혈전소실시간、치료기간신발혈전전새사건이급출혈사건。결과：량조환자재년령、성별、합병질병、혈전대소급약물치료등방면차이균무통계학의의。여화법림조비교，리벌사반조적혈전소실시간축단[（60.00±5.50）d vs （71.00±8.50）d，P<0.01]；량조적신발혈전전새사건（뇌전새、체순배전새）차이무통계학의의（P>0.05），화법림조출혈사건다우리벌사반조，단차이야무통계학의의（P>0.05）。결론：치료좌심실심첨부혈전리벌사반교화법림기효경쾌，불증가출혈풍험。
Objective: To compare the safety and efifcacy of rivaroxaban and warfarin for treating the patients with left ventricular thrombus. Methods: A total of 31 patients with left ventricular thrombus were studied, the patients were randomly divided into 2 groups:Warfarin group, n=16, the patients initially received oral warfarin and low molecular weight heparin at (2.5-3) mg/day, when the INR value reached 2.0-3.0, heparin was stopped and warfarin was continued, the INR value was monitored every 3 days for 3 times, when INR value was stably kept at 2.0-3.0, it was then monitored for every 2 weeks. Rivaroxaban group,n=15, the patients received oral rivaroxaban at 10 mg twice a day. All patients were followed-up for 3 months, the thrombus remission time, new onset of thrombosis, embolism and bleeding events during treatment period were compared between 2 groups. Results: The patients’ age, gender, complication, size of thrombus and medication were similar between 2 groups. Compared with Warfarin group, Rivaroxaban group had the shorter thrombus remission time, (60.00±5.50)d vs (71.00±8.50) d,P<0.01, while the new onset of thrombosis and embolism events as cerebral embolism and systemic embolism were similar between 2 groups, Warfarin group had slightly higher bleeding events, allP>0.05. Conclusion: Rivaroxaban had better effect than warfarin for treating the patients with left ventricular thrombus without increasing the risk of bleeding.
