利伐沙班与华法林治疗左心室心尖部血栓的疗效比较-国家心血管病中心.PDFVIP

中国循环杂志 2015 年 6 月 第 30 卷 第 6 期（总第 204 期）Chinese Circulation Journal，June，2015，Vol. 30 No.6（Serial No.204） 559 临床研究 利伐沙班与华法林治疗左心室心尖部血栓的疗效比较 李秀芬，葛振嵘，帕尔哈提·吐尔逊 摘要 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，P0.01]；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（P0.05），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（P0.05）。 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。 关键词 利伐沙班；华法林；左心室心尖部血栓；抗凝药 Comparative Study of Rivaroxaban and Warfarin for Treating the Patients With Left Ventricular Thrombus LI Xiu-fen, GE Zhen-rong, PAERHATI•Tuerxun. Center of Cardiology, Traditional Hospital of Chinese Medicine Affiliated to Xinjiang Medical University, Urumqi (830001), Xinjiang, China Corresponding Author: PAERHATI•Tuerxun, Email: 121327a@ Abstract Objective: To compare the safety and efficacy 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