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目的调查分析我院非瓣膜性房颤(NVAF)住院患者抗凝药物使用情况并对其临床反应进行评价,以促进临床合理使用抗凝药物。方法采集2015年6月至2017年2月于我院住院的NVAF患者共129例,对患者一般资料(性别、年龄、房颤类型、合并疾病等)、血栓栓塞风险(CHA_2DS_2-VASc评分)、出血风险(HAS-BLED评分)、抗栓药物使用及临床反应情况进行分析评价。结果 129例研究对象中,接受抗凝血药物治疗(抗凝组)26例(20.16%),其中华法林25例(19.38%),达比加群酯1例(0.78%);接受抗血小板治疗(抗血小板组)84例(65.12%),其中阿司匹林54例(41.86%),氯吡格雷26例(20.16%),双抗(阿司匹林和氯吡格雷)3例(2.33%),西洛他唑1例(0.78%);未接受抗栓药物治疗者19例(14.72%)。抗凝组和抗血小板组出血事件分别为3例(11.54%)和6例(7.14%),血栓栓塞事件分别为0例和2例(2.38%),两组患者出血和栓塞事件发生率差异无统计学意义(P>0.05)。结论我院NVAF患者接受合理抗凝药物治疗比例低,临床中仍有一半以上患者使用抗血小板药物治疗,与指南要求尚有一定差距。
Objective To investigate the use of anticoagulant drugs in hospitalized patients with non-valvular atrial fibrillation (NVAF) and evaluate their clinical response in order to promote the rational use of anticoagulant drugs. Methods A total of 129 patients with NVAF admitted to our hospital from June 2015 to February 2017 were enrolled in this study. The general data (gender, age, type of atrial fibrillation, combined disease, etc.), risk of thromboembolism (CHA_2DS_2-VASc score) Bleeding risk (HAS-BLED score), the use of antithrombotic drugs and clinical response analysis and evaluation. Results Of the 129 study subjects, 26 (20.16%) were treated with anticoagulant therapy (anticoagulant therapy), of which 25 (19.38%) were warfarin and 1 (0.78%) was dabigatran etexilate 84 (65.12%) patients were treated with platelet (antiplatelet), including aspirin 54 (41.86%), clopidogrel 26 (20.16%), double antibody aspirin and clopidogrel (2.33% One patient (0.78%) received losartazole; 19 patients (14.72%) did not receive antithrombotic therapy. There were 3 cases (11.54%) and 6 cases (7.14%) of bleeding in the anticoagulant group and antiplatelet group, 0 cases in the thromboembolic event and 2 cases (2.38%) in the anticoagulant group and the antiplatelet group respectively. The incidence of bleeding and embolic events in the two groups were different No statistical significance (P> 0.05). Conclusions In our hospital, NVAF patients with low proportion of patients receiving reasonable anticoagulant therapy, more than half of patients in clinical use of antiplatelet drugs, and the guidelines require a certain gap.