利伐沙班与华法林对心房颤动伴左心房血栓形成患者的疗效观察

吕程，何燕，许键，罗蓓蓓，钟国强，黄伟强，文伟明，韦哲，吴龙飞，张正楠

临床研究

利伐沙班与华法林对心房颤动伴左心房血栓形成患者的疗效观察

吕程，何燕，许键，罗蓓蓓，钟国强，黄伟强，文伟明，韦哲，吴龙飞，张正楠

目的：观察利伐沙班与华法林对心房颤动（房颤）伴左心房血栓形成患者的溶栓疗效及安全性。

方法：选取在我院就诊并确诊为有血栓形成的非瓣膜性房颤患者40例，按患者入院时间随机分为利伐沙班组20例和华法林组20例，利伐沙班组患者应用利伐沙班进行治疗，华法林组患者应用华法林进行治疗，观察期为6个月。比较两组患者左心房血栓溶解率、血栓栓塞率及出血发生率。

结果：利伐沙班组附壁血栓溶解率85.0%，华法林组附壁血栓溶解率70.0%，两组比较差异无统计学意义（P＞0.05）；利伐沙班组血栓栓塞率5%，华法林组血栓栓塞率5%，两组比较差异无统计学意义（P＞0.05）。利伐沙班组出血率5.0%，华法林组出血率10.0%，两组比较差异亦无统计学意义（P＞0.05）。

结论：利伐沙班在非瓣膜性房颤伴左心房血栓形成患者中溶解左心房血栓的疗效方面与华法林一致，血栓栓塞和出血风险两者比较没有显著的差异。

心房颤动；血栓形成；利伐沙班

Objective: To observe the clinical effcacy and safety of rivaroxaban and warfarin in patients with atrial fbrillation (AF) combining left atrial (LA) thrombosis.

Methods: A total of 40 patients with confrmed diagnosis of non-valvular AF in our hospital were studied. According to drug therapy at admission, the patients were divided into 2 groups: Rivaroxaban group and Warfarin group, n=20 in each group. All patients were observed for 6 months and the incidences of LF thrombus resolution, thromboembolism, bleeding events were compared between 2 groups.

Results: In Rivaroxaban group and Warfarin group, the rates for LA thrombus resolution were 85.0% and 70.0%, P＞0.05; for thromboembolism were 5.0% and 5.0%, P＞0.05; for bleeding events were 5.0% and 10.0%, P＞0.05.

Conclusion: Rivaroxaban had the same effect with warfarin on thrombus resolution in patients with non-valvular AF combining LA thrombosis; the medication incurred risks of thromboembolism and bleeding events were similar between 2 drugs.

(Chinese Circulation Journal, 2016,31:1098.)

心房颤动（房颤）为临床上常见的心律失常类型，发病率随着年龄的增长而增加[1]。左心房血栓形成在房颤患者中的发生率为10%～30%[2]，血栓脱落可引起脑动脉栓塞，是房颤患者致残率、致死率最高的并发症。有资料显示，非瓣膜病房颤患者卒中的风险为无房颤者的5.6倍[3]。……